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Bringing overall blood pressure down may increase the danger of falls.

Despite the challenges of treating hypertension in older patients, researchers emphasize the importance of controlling high blood pressure.

"If you can take someone with a systolic blood pressure of 180 and get it down to 150, you knock the tar out of the stroke rate," says Izzo.

And especially as people get older, a stroke can prove much more calamitous than heart disease. Medications that work well for younger people with hypertension can be dangerous in older patients.

Ambulatory testing can identify people whose pressure doesn't fall during the night, as it should.

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"I'd treat a very healthy 80-year-old as I would any [middle-aged] hypertensive.Once you hit age 60, though, it's the upper number — the systolic pressure — that can really climb, causing concern.Systolic hypertension occurs when the arteries close to the heart begin to stiffen, making them less responsive to blood flow.Most people's numbers are higher during the day and lower during sleep. » So how do you know if you really have high blood pressure?First, make sure that the office reading is done correctly.

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