3. Damage to mitochondria must be addressed.
4. The use of beta-blocking drugs to treat hypertension in patients prior to age 65 and from age 65 to 80 may
favorably alter myocardial processes and decrease the incidence of heart failure. This hypothesis needs to be tested. There are more than 12 beta-blocking drugs currently available, but subtle differences exist and carvedilol, bisoprolol, or metoprolol should be used in clinical trials for hypertension and heart failure and the use of atenolol, propranolol, sotalol, acebutolol, and other beta-blockers that are not shown to be cardio-protective in randomized clinical trials should be avoided. 5. Polypharmacy is common in the elderly. The majority of elderly patients take more than eight to 12 pills daily. Drug interactions occur commonly and results in a significant number of deaths that should be avoided by appropriate research and education to patients, physicaians and nurses who render care for the elderly. Renal dysfunction is a common occurence in the elderly, and importantly, a normal blood creatinine may be present in patients with significantly compromised renal function that can lead to drug toxicity.

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