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NHLBI: Systolic Hypertension, Elevated Pulse Pressure Need Treatment, Especially in the Elderly

KEY POINT

Systolic blood pressure should become the principal clinical end point for the detection, evaluation, and treatment of hypertension, the National Heart, Lung, and Blood Institute (NHLBI) said in a recent statement. A related parameter, pulse pressure, may be an even more important predictor of the risk of stroke, myocardial infarction, heart failure, kidney failure, and overall cardiovascular disease mortality and morbidity. For treatment of isolated systolic hypertension in older patients, thiazide diuretics (with or without beta-blockers) and long-acting calcium channel blockers are indicated.

SOURCES

Frohlich ED. Recognition of systolic hypertension for hypertension [editorial]. Hypertension. 2000;35:1018–20.

Izzo JL Jr et al. Importance of systolic blood pressure in older Americans. Hypertension. 2000;35:1021–4.

Schrier RW. Diuretic treatment of systolic hypertension in the elderly [editorial]. Hypertension. 2000;35:1031.

Franse LV et al. Hypokalemia associated with diuretic use and cardiovascular events in the Systolic Hypertension in the Elderly Program. Hypertension. 2000;35:1025–30.

Wilkinson IB et al. Isolated systolic hypertension: a radical rethink [editorial]. BMJ. 2000;320:1685.

Vaccarino V et al. Pulse pressure and risk for myocardial infarction and heart failure in the elderly. J Am Coll Cardiol. 2000;36:130–8.