Spironolactone for the treatment of isolated systolic hypertension

Target blood pressure for treatment of isolated systolic hypertension in the elderly: valsartan in elderly isolated systolic hypertension study.

In this prospective, randomized, open-label, blinded end point study, we aimed to establish whether strict blood pressure control (<140 mm Hg) is superior to moderate blood pressure control (> or =140 mm Hg to <150 mm Hg) in reducing cardiovascular mortality and morbidity in elderly patients with isolated systolic hypertension. We divided 3260 patients aged 70 to 84 years with isolated systolic...

New issues in the treatment of isolated systolic hypertension.

Before commenting on the findings in this article, I will provide a bit of background. ISH is the most common form of hypertension in those older than 65 years.2 Because this segment of the population is expanding so rapidly, ISH will soon be the most prevalent form of hypertension. Over the last few years, a paradigm shift has occurred, away from the prior concern over an elevation of diastoli...

Isolated systolIc hypertensIon

Until the 1980’s the diastolic blood pressure (DBP) was assumed to be the most relevant hemodynamic parameter for prognosis of hypertensive patients. Elevated systolic pressure was considered as an inevitable consequence of aging and many physicians were reluctant to pay credence to the need for therapy of elevated systolic blood pressure. There was a radical change in thinking based on epidemi...

Risk and benefit of treatment of isolated systolic hypertension in the elderly: evidence from the Systolic Hypertension in Europe Trial.

The Syst-Eur trial investigated whether active treatment starting with the dihydropyridine calcium channel blocker (CCB) nitrendipine, could reduce the cardiovascular complications of isolated systolic hypertension (ISH) in the elderly. The intention-to-treat analysis showed that active treatment improved outcome. The per-protocol analysis largely confirmed these results. The effect of treatmen...

Isolated systolic hypertension: cardiovascular risk and treatment benefits.