Pathophysiological aspects and the consequences of hypertension may differ between younger and older patients. The aim of the present study was to explore the specificity of hypertension-mediated organ damage (HMOD) and secondary forms in patients≥65years in comparison to younger ones in a contemporary cohort.

A total of 938 hypertensive patients who had at baseline HMOD and secondary forms screening were included among them 190 were≥65years.

The mean±SD number (2.1±0.8 vs. 1.2±0.9, P<0.001) and frequency of HMOD (96.3% vs. 72.9%, P<0.001) was higher in patients≥65years than younger ones. Carotid femoral pulse wave velocity>10m/s was the most frequent HMOD in patients≥65years (90.1%), while echocardiographic left ventricular hypertrophy was the most common in the younger patients (45.0%). Among ECG left ventricular ECG indexes, only R wave in aVL lead was significantly more frequently observed in patients≥65years (32.6%) than in younger ones (19.0%, P<0.001). The frequency of secondary hypertension was not significantly different between younger and older patients (respectively; 30.5% vs. 27.8%, P=0.487). The most frequent aetiology was primary aldosteronism regardless of age. The frequency of renovascular hypertension was higher in patients≥65years (6.3% vs. 3.3%, P=0.038). Among older patients, 3.2% were treated with adrenalectomy (primary aldosteronism or Cushing syndrome) and 6.3% with percutaneous transluminal renal angioplasty.

In a tertiary centre, secondary forms of hypertension have a similar frequency in both subgroups. Extensive screening of HMOD in patients aged≥65years may be questionable because of its very high frequency.