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Life sciences · Journal article
Problems of Ageing and Longevity · September 24, 2026
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The question of when and to what target values elevated blood pressure (BP) should be reduced in elderly and very elderly patients remains one of the most debated issues in contemporary geriatric cardiology. Unlike middle-aged adults, in whom the relationship between BP level and cardiovascular risk follows a clear linear pattern, in geriatric patients this relationship takes on a more complex — and often J-shaped — character. The present review systematises the evidence base from major randomised controlled trials and clinical guidelines, examines controversial concepts — the J-curve phenomenon, the compensatory role of moderate hypertension in elderly patients, and the sex dimorphism of therapeutic risks — and outlines a contemporary strategy for safe antihypertensive management in old and very old age.