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Treating isolated systolic hypertension in the elderly
1Department of Pharmacy, University of Kansas Medical Center, Kansas City 66160.
The Annals of Pharmacotherapy
|March 1, 1994
Summary
Isolated systolic hypertension (ISH) in the elderly is common and increases vascular disease risk. Effective drug treatment, particularly with diuretics, significantly reduces cardiovascular and cerebrovascular events.
Area of Science:
- Gerontology
- Cardiology
- Pharmacology
Background:
- Isolated systolic hypertension (ISH) is prevalent in the elderly.
- ISH is linked to increased cardiovascular and cerebrovascular disease risk.
- Reduced arterial compliance is the primary suspected cause of ISH in older adults.
Purpose of the Study:
- To review the prevalence of ISH in the elderly.
- To examine the pathophysiology and vascular risk associated with ISH.
- To evaluate the treatment options for ISH in the elderly population.
Main Methods:
- A comprehensive MEDLINE search of English-language literature was conducted.
- Key search terms included "hypertension," "systolic," and "elderly."
- Studies on drug therapy for ISH and review articles were selected for analysis.
Main Results:
- ISH is common in the elderly and elevates vascular disease risk.
- The Systolic Hypertension in the Elderly Program showed diuretics and beta-blockers significantly reduce strokes and cardiovascular events.
- Drug therapy for ISH in the elderly was safe and well-tolerated; newer agents' long-term effects are unknown.
Conclusions:
- ISH is a significant risk factor for vascular disease in older adults.
- Accurate diagnosis and effective drug treatment of ISH reduce vascular event risk.
- Diuretics are first-line treatment for ISH; beta-blockers are considered for combination therapy. Further research on newer agents is needed.
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