Isolated systolic hypertension in the elderly

  title={Isolated systolic hypertension in the elderly},
  author={Claudia U. Chae and Donald M Jones},
  journal={Current Treatment Options in Cardiovascular Medicine},
  • C. Chae, Donald M Jones
  • Published 1 February 2002
  • Medicine
  • Current Treatment Options in Cardiovascular Medicine
Opinion statementIsolated systolic hypertension (ISH) is the predominant form of hypertension in persons older than 50 years, who represent the majority of individuals with hypertension. Systolic blood pressure (SBP) determines Joint National Committee blood pressure stage, and therefore the need for therapy, far more often than diastolic blood pressure (DBP). SBP consistently is associated with greater risk for overall mortality, coronary heart disease, stroke, congestive heart failure, renal… 
Effects of body mass index, plasma glucose and cholesterol levels on isolated systolic hypertension.
Hypertension and cognitive function. Blood pressure regulation and cognitive function: a review of the literature.
Although single drug therapy is effective in treating hypertension, most patients will require combination drug treatment, and combination therapy--typically a diuretic with an ACE inhibitor, an ARB, or a beta blocker--is appropriate for treatment of older patients, is well tolerated, and can effectively preserve cognitive function.


Clinical trials in isolated systolic hypertension
The pooled results of the outcome trials in older patients with isolated systolic hypertension prove that antihypertensive drug treatment must be prescribed if, on repeated measurement, syStolic blood pressure is 160 mm Hg or higher.
Is there a preferred antihypertensive therapy for isolated systolic hypertension and reduced arterial compliance?
Certain drugs like nitrates, angiotensin converting enzyme inhibitors, and other drugs affecting the renin-angiotens in system have multiple actions that improve large artery stiffness and early wave reflection and are especially useful in treating ISH in the elderly.
Pulse Pressure Not Mean Pressure Determines Cardiovascular Risk in Older Hypertensive Patients
In older hypertensive patients, pulse pressure not mean pressure is the major determinant of cardiovascular risk, according to a meta-analysis based on individual patient data.
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Pulse pressure appears to be the best single measure of blood pressure in predicting mortality in older people and helps explain apparently discrepant results for low diastolic blood pressure.
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This clinical advisory statement from the Coordinating Committee of the National High Blood Pressure Education Program is intended to advance and clarify the recommendations of the Sixth Report of
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  • Medicine
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In persons aged 60 years and over with isolated systolic hypertension, antihypertensive stepped-care drug treatment with low-dose chlorthalidone as step 1 medication reduced the incidence of total stroke by 36%, with 5-year absolute benefit of 30 events per 1000 participants.
Increased pulse pressure and risk of heart failure in the elderly.
Pulse pressure, an easily measurable correlate of pulsatile hemodynamic load, is an independent predictor of risk of CHF in this elderly cohort of men and women.