Hypertension in the elderly patient.
Several trials have demonstrated a significant reduction in morbidity from cardiovascular disease with the treatment of diastolic hypertension in elderly persons. The pilot trial of the Systolic Hypertension in the Elderly Patient study showed a reduction in morbidity and mortality from stroke with less of a reduction in death from cardiac conditions in elderly patients who were treated. Isolated systolic hypertension in elderly persons has a particularly hazardous connection with morbidity and mortality from stroke and cardiovascular disease. The mechanisms of hypertension are different, if not greatly so, in the elderly population. Peripheral vascular resistance plays a major role. However, reduction in peripheral vascular resistance can still be demonstrated with exercise in older patients. Two major studies are ongoing--the Systolic Hypertension European trial and the Systolic Hypertension in the Elderly Patient trial. We await the outcome of these trials to learn more about the treatment of isolated systolic hypertension in elderly patients.
San Francisco Heart Institute, Daly City, CA 94015.
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Ryan
D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D014655:Vascular Resistance / Q000187:drug effects
D000959:Antihypertensive Agents