The problems of hypertension in the elderly.

The cut off age for elderly person in India is 60-65 years, in the USA is 75-80 years and 6th Joint Committee on Detection, Evaluation and Treatment of High Blood Pressure (JNC-VI) has identified it as above 60 years. Elderly people may have (i) systolic-diastolic hypertension, (ii) isolated systolic hypertension or (iii) pseudohypertension. JNC-VI has classified hypertension in stage 1, stage 2 and stage 3 according to its severity. Hypertension is confirmed when BP measured on three separate occasions over 1-2 weeks and when consistently it is raised above 140/90 mm Hg. The management includes lifestyle modification and drug treatment. Lifestyle modification includes rationality of diet, regular exercise, stop smoking, stoppage of alcohol or moderation and yoga. Drugs commonly used are diureties and beta-blockers. Other antihypertensive drugs are calcium channel blockers, ACE-inhibitors, alpha-blockers and vasodilators.

Hazards of smoking.

A strong association exists between cigarette smoking and several diseases namely, cancer of the lung, bronchitis and emphysema, cancer of the larynx, oral cavity and oesophagus, gastric and duodenal ulcers, Crohn's disease, cancer of the bladder, coronary artery disease, macrocytosis, polycythaemia, leukaemia, etc. This is due to the harmful constituents of cigarette and other modalities smoking. Smokers not only harm themselves but also harm those around. Foetal malformations, abortions, stillbirths, prematurity and low birth weight are common in smoker mothers. These are the effects of passive smoking. There is no safer cigarette in the market even by lowering its harmful constituents. Mass education about the hazards of smoking with emphasis on complete stoppage of smoking is the only way to prevent its rising incidence.