High blood pressure is a cardiovascular risk factor in children and younger women as well as other patients, particularly because they normally have a lower blood pressure than the average for the population. Moderately elevated values are usually associated with a sedentary lifestyle, diet and uncontrolled obesity, and can be returned to normal limits by making lifestyle improvements in children. The finding of very high values must be supervised and monitored in a specialist medical environment.
Women of childbearing age may see their blood pressure rise as a result of taking contraceptives. But the condition most frequently associated with hypertension in young women is pregnancy, where hypertension can be pre-existing (and exacerbated by the pregnancy) or appear in the course of, or at the end of the pregnancy, or may even be a more severe form called pre-eclampsia. To control hypertension in pregnancy, a general improvements in lifestyle is mandatory and, sometimes, treatment with drugs, usually based on methyldopa, labetalol or nifedipine, can be recommended.
ACE inhibitors and Sartans should be avoided by women at risk of pregnancy, because of possible adverse effects on the foetus.
The elderly are generally treated the same way as younger patients, especially when they are in a good general state of health (see "What pressure should be targetted?"). In the very elderly, it is still important not to reduce the pressure too rapidly.