The incidence of hypertension increases with age. Although there is ample evidence regarding the benefit of treating elderly hypertensive patients, resulting in decreases in cardiovascular morbidity and mortality, the adverse effects of treatment are also frequently reported in these often frail individuals. Therefore, it is difficult to determine the level to which blood pressure should be decreased and what type of antihypertensive medication is most effective and best tolerated. The approach to treating hypertension in octogenarians at the Cleveland Clinic Florida was reviewed. An analysis of 100 consecutive charts of hypertensive octogenarians treated by internists from January 1, 1993, with a minimum of 1 year follow up, was carried out. The mean age of the population studied was 84.7 years (range, 80-97Â+/-4.13 years). The mean initial blood pressure was 152/83 mm Hg, and the mean final blood pressure was 145/76 mm Hg (pless than 0.01). The initial number of medications used was 1.2, which rose to 1.6 by the final reading (pless than 0.0001). The most frequently used drug classes were calcium channel blockers, followed by diuretics and ACE inhibitors. Most of the octogenarians tolerated their antihypertensive medication well. (c)2000 by Le Jacq Communications, Inc.