The Dark Side of the Swoon: antihypertensive treatment in the elderly.

We would like to thank Prof. Dal Moro for his valuable contribution[1]. Indeed, many patients, especially those who are older and who suffer from several concomitant diseases, are at risk of being "overtreated with good intentions". The main problem is that the diagnosis of essential hypertension is at times assigned very liberally based on a single ambulatory measurement without taking into consideration the natural history and variation of systemic blood pressure[2]. The orthostatic intolerance is often asymptomatic and thus not being looked for. Consequently, the antihypertensive treatment may additionally reduce blood pressure on standing and lead to unexpected syncopal attacks. This article is protected by copyright. All rights reserved. (Less)