title: Isolated Systolic Hypertension: An Update After SPRINT.
abstract: Isolated systolic hypertension is the most common hemodynamic form of hypertension in the elderly. With a rapidly aging population, the prevalence of hypertension, particularly isolated systolic hypertension, is expected to increase substantially. This phenomenon of increasing systolic pressure in the elderly is believed to be secondary to pathophysiological changes of aging as well as modifiable risk factors. Isolated systolic hypertension is associated with substantial mortality and morbidity, particularly of cerebrovascular disease. It is a rapidly growing public health concern and its management continues to remain a challenge to practicing physicians. Recent studies like the Systolic Blood Pressure Intervention Trial (SPRINT) and Heart Outcomes Prevention Evaluation (HOPE)-3 have implications for antihypertensive therapy in general and for the management of isolated systolic hypertension in particular. In this article we will review: 1) epidemiology and pathophysiologic mechanisms, 2) impact of isolated systolic hypertension on cardiovascular outcomes, 3) optimal management strategies, and 4) systolic blood pressure goals in the light of SPRINT and HOPE 3 trials.
authors.affiliation: Department of Cardiology, Mount Sinai St. Luke's and Mount Sinai West Hospitals, New York, NY.
authors.forename: Chirag
authors.initials: C
authors.lastname: Bavishi
authors.affiliation: Department of Cardiology, Mount Sinai St. Luke's and Mount Sinai West Hospitals, New York, NY; Department of Critical Care Medicine, Mayo Clinic, Rochester, Minn.
authors.forename: Sangita
authors.initials: S
authors.lastname: Goel
authors.affiliation: Department of Cardiology, Mount Sinai Health Medical Center, Icahn School of Medicine, New York, NY; University Hospital, Bern, Switzerland; Jagiellonian University, Krakow, Poland. Electronic address: messerli.f@gmail.com.
authors.forename: Franz H
authors.initials: FH
authors.lastname: Messerli
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000375:Aging / Q000502:physiology; D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000209:etiology / Q000517:prevention & control; D004095:Dihydropyridines / Q000627:therapeutic use; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D017678:Sex Distribution; D049993:Sodium Chloride Symporter Inhibitors / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers; D004095:Dihydropyridines; D049993:Sodium Chloride Symporter Inhibitors
keywords: Elderly; Hypertension; Systolic