The Effect of Hypertension Treatment on the Prevention of Coronary Artery Disease Events in the Elderly.
Both isolated systolic (greater than 140/ less than 90 mm Hg) and systolic/diastolic ( greater than 140/ greater than 90 mm Hg) hypertension have been identified as major risk factors for cardiovascular disease in the elderly. Effective specific antihypertension therapy is available if lifestyle intervention fails to reduce blood pressure to normal levels. Long term placebo-controlled trials, primarily with diuretics and beta-blockers, have demonstrated not only a reduction in cerebrovascular events but in CHD events as well. A significant reduction in the occurrence of CHF and progression of less severe to severe hypertension has also been demonstrated in treated compared to placebo subjects. A recent study suggests that the use of one of the moderately long acting dihydropyridine CCBs nitrendipine (not available in the U.S.) may also reduce the occurrence of strokes in elderly subjects with ISH
Moser
Marvin
M
Department of of Medicine, Yale University School of Medicine, New Haven, CT.