Document Detail

Systolic hypertension in the elderly: addressing an unmet need.
MedLine Citation:
PMID:  18328297     Owner:  NLM     Status:  MEDLINE    
Systolic hypertension is a major public health issue in the elderly and is often under-recognized and under-treated. The concept that systolic blood pressure increases with age should be considered a pathophysiologic concept. Aging of the cardiovascular system is accompanied by endothelial dysfunction, activation of the renin-angiotensin system and, consequently, vascular remodeling. This process leads to an increase in large artery stiffness and an increase in arterial wave reflections to the heart. These processes in daily clinical practice translate to an increase in systolic blood pressure, which is associated with increased cardiovascular morbidity and mortality. Evidence-based medicine recommendations to treat systolic hypertension in the elderly are based on landmark and recent clinical trials, which clearly demonstrated that treatment of isolated systolic hypertension is associated with significant decreases in cardiovascular morbidity and mortality. However, treatment of systolic hypertension in older adults remains disappointing because therapeutic goals often are not reached. Therefore, emphasis should be placed on the treatment of systolic hypertension in the elderly, and there is need for more effective, individualized antihypertensive therapy.
Daniel A Duprez
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  The American journal of medicine     Volume:  121     ISSN:  1555-7162     ISO Abbreviation:  Am. J. Med.     Publication Date:  2008 Mar 
Date Detail:
Created Date:  2008-03-10     Completed Date:  2008-03-27     Revised Date:  2008-09-18    
Medline Journal Info:
Nlm Unique ID:  0267200     Medline TA:  Am J Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  179-184.e3     Citation Subset:  AIM; IM    
Cardiovascular Division, Medical School, University of Minnesota, MN 55455, USA.
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MeSH Terms
Antihypertensive Agents / therapeutic use*
Hypertension / drug therapy*
Reg. No./Substance:
0/Antihypertensive Agents
Comment In:
Am J Med. 2008 Sep;121(9):e21, author reply e23   [PMID:  18724948 ]
Am J Med. 2008 Sep;121(9):e15   [PMID:  18724945 ]

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