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[Isolated systolic arterial hypertension in the elderly]
B Ivanović-Krstić1, D Cvetković-Matić, Dj Nikcević
1Institute Cardiovascular Diseases, Clinical Centre of Serbia, Belgrade.
Srpski Arhiv Za Celokupno Lekarstvo
|December 24, 1998
Summary
Treatment of isolated systolic hypertension in the elderly with diuretics or beta blockers significantly reduces stroke and cardiovascular events. Further research is needed on newer agents for long-term outcomes.
Area of Science:
- Gerontology
- Cardiovascular Medicine
- Hypertension Research
Context:
- Isolated systolic hypertension (ISH) is prevalent in the elderly, posing significant risks for stroke and cardiovascular disease.
- Arterial stiffening, a hallmark of aging, is the primary driver of elevated systolic pressure in older adults.
- ISH diagnosis can be challenging due to blood pressure variability, often requiring ambulatory monitoring.
Purpose:
- To evaluate the efficacy of antihypertensive treatments in mitigating cardiovascular and cerebrovascular complications associated with ISH.
- To review recent clinical trials investigating the impact of pharmacological interventions on ISH outcomes in the elderly population.
Summary:
- Recent trials (STOP-Hypertension, SHEP, MRC) demonstrate that diuretics and/or beta blockers effectively reduce stroke and major cardiovascular events in elderly patients with ISH.
- Combination therapy with diuretics and beta blockers showed significant benefits.
- Newer agents like calcium channel blockers and ACE inhibitors lower systolic blood pressure but require further study for long-term effects.
Impact:
- Treatment of ISH with established agents like diuretics and beta blockers offers a clear benefit in reducing morbidity and mortality.
- Evidence supports the use of these medications for preventing serious cardiovascular and cerebrovascular events in older adults.
- Further investigation is warranted to establish the long-term safety and efficacy of novel antihypertensive drugs for ISH.