Cardiovascular disease is a leading cause of mortality in the elderly. Hypertension is an important modifiable risk factor that contributes to cardiovascular morbidity and mortality. The prevalence of hypertension is known to increase with age, and hypertension has been associated with an increase in risk for cardiovascular disease in the elderly. There is a wealth of evidence that supports aggressive control of blood pressure to lower cardiovascular risk in the general population. However, there are limited data to guide management of hypertension in the elderly and frail patient subgroups. These subgroups are inadequately treated due to lack of clarity regarding blood pressure thresholds, treatment targets, comorbidities, frailty, drug interactions from polypharmacy, and high cost of care. Areas covered: We review the current evidence behind the definition, goals, and treatments for hypertension in the elderly and frail and outline a strategy that can be used to guide antihypertensive pharmacotherapy in this population. Expert commentary: Lower blood pressure to < 130/80 mm Hg in elderly patients if tolerated and promote use of combination therapy if the blood pressure is > 20/10 mm Hg over the goal blood pressure. Antihypertensive treatment regimens must be tailored to each individual based on their comorbidities, risk for adverse effects, and potential drug interactions ( Figure 1 ).

Progression, rate of metastases and survival for patients diagnosed with bilateral small renal masses are similar to those diagnosed with unilateral disease.

The process of routing in MANET (Mobile ad hoc network) requires a trust based environment and therefore security is one of the major concern. A backbone network in a MANET is difficult when it is implemented for a specific application. A security based environment is one of the most critical issues in a MANET because it is mostly involved with sensitive and secret information. This work deals with a specific type of denial-of-service (DOS) attack called node isolation attack and thus analyze the vulnerabilities of a pro-active routing protocol called optimized link state routing (OLSR). Based on this analysis, this work proposes a mechanism called enhanced OLSR (EOLSR) protocol which is a trust based technique to secure the OLSR nodes against the attack. According to the proposed technique, isolation can be detected by the hello packets it sends. Verification is done through this, whether a node is advertising correct topology information or not thus leading to detection of the isolation node that perform the DOS attack. Enhanced OLSR is further improved using the trust based system called Trustbased OLSR (TOLSR). Once the node is detected as attacker using EOLSR, its trust value is reduced to half of its initial value. Hence in future, selection of attacker as MPR node is prevented since all the nodes will select only high trust node as MPR node. The concept of ensuring security to the network does not involve much computational complexity and therefore, the proposed scheme is a light weight technique.