[Isolated systolic hypertension in the elderly]

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P Gareri1, M Olivo, D Ciotti

  • 1Facoltà di Medicina e Chirurgia, Dipartimento di Medicina Sperimentale e Clinica, Cattedra e Scuola di Specializzazione in Geriatria, Policlinico Materdomini, Università degli Studi, Catanzaro, Italy.

Minerva Medica
|December 12, 2001
PubMed

Insights

Isolated systolic hypertension is common in older adults and a risk factor for cardiovascular disease. Effective treatment involves lowering systolic blood pressure while preserving diastolic pressure, with specific medications showing promise.

Area of Science:

  • Geriatric Medicine
  • Cardiovascular Research
  • Pharmacology

Context:

  • Isolated systolic hypertension (ISH) is the predominant form of hypertension in the elderly population.
  • ISH is recognized as an independent risk factor for significant cardiovascular morbidity and mortality.

Purpose:

  • To review the prevalence, pathophysiology, diagnosis, and treatment strategies for isolated systolic hypertension in the elderly.
  • To highlight optimal therapeutic approaches for managing ISH, focusing on systolic and diastolic blood pressure targets.

Summary:

  • The review emphasizes that the ideal treatment for ISH aims to maximize systolic blood pressure reduction while minimizing diastolic blood pressure reduction.
  • Antihypertensive agents, particularly calcium antagonists, ACE-inhibitors, and angiotensin II antagonists, are noted for their efficacy in improving large artery stiffness, making them suitable for elderly patients with ISH.
  • Careful patient evaluation and consideration of polypharmacy are crucial for selecting appropriate medications and avoiding adverse drug interactions.

Impact:

  • Provides a comprehensive overview of ISH management in the elderly.
  • Guides clinicians in selecting effective antihypertensive agents for ISH, considering vascular properties and patient-specific risk factors.
  • Underscores the importance of individualized treatment plans to mitigate cardiovascular risks associated with ISH.

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