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Improved Outcomes with Antihypertensive Medication in the Elderly with Isolated Systolic Hypertension

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Abstract

Isolated systolic hypertension affects over 15% of all individuals aged >60 years. In the elderly, systolic hypertension is a major modifiable cardiovascular risk factor. Systolic blood pressure (SBP) is associated with higher risk of an adverse outcome, whereas diastolic blood pressure (DBP) is inversely correlated with total mortality, independent of SBP, highlighting the role of pulse pressure as a risk factor.

Three placebo-controlled outcome trials on antihypertensive drug treatment in older patients with isolated systolic hypertension have been published: the Systolic Hypertension in the Elderly Program (SHEP), the Systolic Hypertension in Europe (Syst-Eur) Trial and the Systolic Hypertension in China (Syst-China) Trial. These 3 trials demonstrated the benefit of antihypertensive drug treatment. A meta-analysis was performed by pooling the patients from these 3 trials with a subset of patients with isolated systolic hypertension from 5 other trials in the elderly. The pooled results of 15 693 older patients with isolated systolic hypertension prove that antihypertensive drug treatment is justified if on repeated clinic measurements SBP is 160mm Hg or higher.

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Authors and Affiliations

  1. Study Coordinating Center, Hypertension and Cardiovascular Rehabilitation Unit, Department of Molecular and Cardiovascular Research, University of Leuven, Leuven, Belgium

    Ji-Guang Wang &  Jan A. Staessen

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  1. Ji-Guang Wang
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  2. Jan A. Staessen
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Correspondence to Jan A. Staessen.

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Wang, JG., Staessen, J.A. Improved Outcomes with Antihypertensive Medication in the Elderly with Isolated Systolic Hypertension. Drugs & Aging 18, 345–353 (2001). https://doi.org/10.2165/00002512-200118050-00005

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