title: Systolic hypertension.
abstract: Approximately one-third of the adult population has hypertension. Large-scale clinical trials have convincingly demonstrated that the treatment of isolated systolic and systolic/diastolic hypertension reduces rates of total mortality, cardiovascular mortality, and stroke in older adults, yet control of systolic hypertension remains poor. This article reviews systolic blood pressure as a cardiovascular risk factor and discusses effective management of elevated systolic blood pressure. The role of combination therapy is emphasized, focusing on the combination of a calcium-channel blocker and an angiotensin-converting enzyme inhibitor. In addition to blood pressure-lowering efficacy, the combination of these two classes of metabolically neutral agents may offer benefit in terms of tolerability and cognitive function.
authors.affiliation: SUNY Upstate Medical University, Syracuse Preventive Cardiology Center, Syracuse, NY, USA.
authors.forename: David T
authors.initials: DT
authors.lastname: Nash
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001794:Blood Pressure; D002121:Calcium Channel Blockers / Q000009:adverse effects / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy*; D015201:Meta-Analysis as Topic; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D011379:Prognosis; D012307:Risk Factors; D020521:Stroke / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D013599:Systole
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers