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Isolated systolic hypertension in the elderly subject
1Service Cardiologie B, CHRU, Poitiers, France.
The European Journal of Medicine
|October 1, 1993
Summary
Treatment for isolated systolic hypertension in older adults significantly reduces stroke and cardiovascular events. This finding highlights the importance of managing high systolic blood pressure in the elderly population.
Area of Science:
- Gerontology
- Cardiovascular Medicine
- Hypertension Research
Background:
- Isolated systolic hypertension (ISH) in the elderly is a growing concern.
- Prevalence varies by demographics and healthcare access.
- ISH is an independent risk factor for cardiovascular morbidity and mortality.
Purpose of the Study:
- To summarize the current understanding of isolated systolic hypertension in the elderly.
- To review the hemodynamic and neurohormonal characteristics of elderly individuals with ISH.
- To discuss the prognostic implications and recent treatment findings for ISH.
Main Methods:
- Review of existing literature on isolated systolic hypertension in the elderly.
- Analysis of hemodynamic and neurohormonal changes associated with aging and hypertension.
- Evaluation of evidence from clinical studies, including the SHEP trial.
Main Results:
- Elderly individuals exhibit reduced cardiac output, renal and hepatic blood flow, diminished great vessel compliance, impaired baroreflex, and right-shifted cerebral autoregulation.
- Isolated systolic hypertension is a significant independent risk factor for cardiovascular events.
- The SHEP study demonstrated that treating ISH with diuretics, alone or with beta-blockers, significantly reduced stroke and major cardiovascular events.
Conclusions:
- Isolated systolic hypertension in the elderly is a critical condition requiring management.
- Treatment with diuretics and beta-blockers is effective in reducing cardiovascular risks.
- Further research is needed to evaluate other antihypertensive agents like ACE inhibitors and calcium antagonists.
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