1.The elderly refers to people aged 65 years and above. 2, the prevalence of the current situation: the prevalence of hypertension in people over 60 years old in China is 49%. Hypertension in the elderly often coexists with a variety of diseases and complications, often complicated by coronary heart disease, heart failure, cerebrovascular disease, renal insufficiency, etc.. Hypertension in the elderly is also often combined with diabetes, arthritis, and digestive diseases. The medication of some diseases can affect blood pressure, for example, arthritis patients who often apply antipyretic and analgesic drugs or glucocorticoids, long-term medication can increase blood pressure. If blood pressure is not well controlled, cardiovascular and cerebrovascular complications will occur very easily. 3, the clinical characteristics of hypertension in the elderly 1) increased systolic blood pressure, increased pulse pressure: simple systolic hypertension in the elderly accounts for 60% of hypertension. Its incidence increases with age, while the incidence of stroke rises sharply. Pulse pressure in the elderly is positively correlated with total mortality and cardiovascular events. 2) High fluctuations in blood pressure: There is an increase in the morning peak of blood pressure, which is the highest blood pressure in the early morning of the day. There is an increase in hypertension combined with upright hypotension and postprandial hypotension. Upright hypotension, also known as postural hypotension, is defined as a decrease in systolic blood pressure greater than 20 mmHg or diastolic blood pressure greater than 10 mmHg within 3 minutes of changing position to an upright position, accompanied by symptoms such as dizziness or syncope; postprandial hypotension in the elderly is defined as: blood pressure measured every 15 minutes for 2 hours after a meal, compared with the pre-meal, systolic blood pressure decreased by more than 20 mmHg, or pre-meal systolic blood pressure is 100 mmHg and above, and postprandial systolic blood pressure is less than 90 mmHg, or although the postprandial blood pressure drop is slight, symptoms of cardiovascular ischemia, such as angina, weakness, syncope, and impaired consciousness, are present. The high fluctuation of blood pressure in the elderly affects the therapeutic effect, and the risk of cardiovascular and cerebrovascular events can be significantly increased when blood pressure fluctuates sharply. 3) Common blood pressure circadian rhythm abnormalities: normal blood pressure is obvious circadian fluctuations, the dynamic blood pressure curve is “double peak a valley”, usually called the spoon type, that is, the lowest blood pressure at night (a valley), in the morning 6:00-10:00 and down 4:00-8:00 each have a peak; elderly hypertensive patients, the incidence of abnormal blood pressure circadian rhythm is high. This is manifested as a decrease in blood pressure at night of less than 10% (non-spoon type) or more than 20% (super-spoon type). This leads to an increased risk of target organ damage, such as heart, brain, and kidney damage. There are also some elderly people whose blood pressure is much higher at night than during the day, and they are prone to cardiovascular and cerebrovascular complications at night. 4) Increased white coat blood pressure. White coat blood pressure is a condition in which the blood pressure measured in the office is consistently elevated, while it is not elevated when outside the office environment, while ambulatory blood pressure monitoring is normal. Most are due to stress. The clinical features of hypertension described above are related to increased stiffness and poor elasticity of the vascular wall in the elderly and reduced function of the blood pressure regulation center. 4.Diagnosis Age 65 years and above, blood pressure is persistently elevated, or more than 3 non-same day sitting blood pressure systolic blood pressure is 140mmHg and above, or diastolic blood pressure is 90mmHg and above; if systolic blood pressure is above 140mmHg and diastolic blood pressure is less than 90mmHg, it is defined as simple systolic hypertension in the elderly. 5, treatment Analysis of elderly hypertension trials showed that antihypertensive treatment can reduce stroke by 40% and cardiovascular events by 30%; whether systolic or diastolic hypertension, or elderly simple systolic hypertension, antihypertensive treatment can reduce the incidence of cardiovascular and cerebrovascular disease and mortality; an average reduction of 10 mmHg systolic blood pressure or 4 mmHg diastolic blood pressure can reduce the risk of stroke by 30% and cardiovascular events and mortality by 13%. Cardiovascular events and mortality were reduced by 13%, with more benefit in older men over 70 years of age, with increased pulse pressure, or with cardiovascular comorbidities. Antihypertensive therapy in older patients with hypertension may reduce overall mortality and the incidence of strokes. The treatment of hypertension in the elderly should emphasize the achievement of systolic blood pressure, that is, systolic blood pressure should be reduced to below 150 mmHg, but diastolic blood pressure should not be lower than 60 mmHg. At the same time, excessive and rapid blood pressure lowering should be avoided; on the premise of tolerating blood pressure lowering treatment, blood pressure should be lowered gradually to achieve the goal; for patients with good blood pressure lowering tolerance, blood pressure lowering treatment should be actively carried out. 90mmHg.