Introduction: Management of antihypertensive treatment in the very elderly is complex in daily hospital clinical practice. The objective of this work is to study the profile of patients who benefit from adaptation of their antihypertensive treatment during hospitalization.

Methods: A descriptive retrospective study was conducted for 5 months, including all patients, hospitalized in an acute geriatric unit, who had an antihypertensive treatment at their entry or exit prescription for antihypertensive drugs.

Results: We included in our study 100 patients, very old (51% over 85 and 16% over 90), predominantly female (sex ratio of 0.4), polymorbid (78% with 3 or more active co-morbidities), polymedicated (71% with more than 5 drugs) and fragile. The antihypertensive treatment was modified in 82 patients, by increasing the treatment in 32 patients and by decreasing in 50 patients. Reasons for intervention were low blood pressure (30%), electrolyte disturbances (17%), dehydration (8%), acute renal failure (8%) and high blood pressure (18%). Univariate and then multivariate analysis revealed that only the presence of renin-angiotensin system treatment (ACE inhibitors and angiotensin II antagonists) at arrival was a significant independent factor associated with a change in antihypertensive treatment (p=0.015, odds ratio at 4.333, CI of 95% at 1.324-14.179).

Conclusion: Individualization of antihypertensive treatment is necessary for each geriatric patient by defining the most suitable target of blood pressure according to the frailty profile.