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Arterial hypertension is the most common cardiovascular risk factor in the elderly. Its clinical control emphasises the problem of the systems used for monitoring: clinical measurement by the physician, home self-monitoring, ambulatory monitoring, etc. In particular, in the elderly population, the self-monitoring of blood pressure can present further problems associated with their situation. In our study we evaluated, in an elderly population, the differences in the self-recording of blood pressure with automatic and semi-automatic equipment using a mercury sphygmomanometer by a physician as a 'gold standard' control. We studied 28 elderly subjects using a rigid protocol for the self-measurement of their blood pressure. Our results show that automatic equipment is significantly more precise and easier to use than semiautomatic equipment in home self-measurement of blood pressure in elderly people.

Both aging and Arterial Hypertension (AH) cause a series of structural and functional changes in the cardiovascular apparatus. The reduction of aortic distensibility (RAD) and left ventricular hypertrophy (LVH) are, in particular, two significant markers of cardiovascular damage apart from being factors of serious and widespread morphological alterations. In this paper, the Authors analyze the effects of aging and of AH on the cardiovascular apparatus in order to find a possible clinical significance in relation to both RAD and LVH.

Objective: An uncontrolled multicentre study was carried out in 10 hospitals of the Marche Region of central Italy, to evaluate the efficacy and tolerability of 40 mg nicardipine retard in elderly hypertensive patients with diabetes mellitus type II., Design: The study lasted 6 months, single-blind for the first 3 months and open thereafter. The blood pressure criteria were 165 mmHg systolic and/or 95 mmHg diastolic measured at least three times consecutively in untreated patients or after 10 days of drug washout., Patients: All subjects had a proven diagnosis of diabetes mellitus type II and were greater than or equal to 65 years of age., Results: After the first 14 days of active treatment with nicardipine [corrected] retard at 40 mg/day, supine systolic blood pressure had fallen to 164.3 +/- 12.7 mmHg and diastolic to 92.2 +/- 7.3 mmHg (P less than 0.001). This first phase normalized blood pressure in 41.1% of patients. In 58.9% of patients the dose was doubled because goal blood pressure had not been achieved. After 4 weeks of therapy, mean supine systolic/diastolic values had fallen to 156.5 +/- 11.0/88.5 +/- 6.8 mmHg (P less than 0.001), and the proportion of patients requiring 80 mg/day had risen to 63.2%, with only 36.8% able to continue on the single dose. In 24.2% of the patients, monotherapy at 80 mg/day was not sufficient to normalize blood pressure and a second associated drug (enalapril, 10 mg/day) was administered. The mean blood pressure decrease induced by therapy was statistically significant from the second week of treatment (P less than 0.001). No significant variation in metabolic parameters was recorded during treatment., Conclusions: Nicardipine [corrected] retard was effective and well tolerated in elderly subjects, both clinically and metabolically.