Clinical trials in isolated systolic hypertension in the elderly

ABSTRACT

The presence of isolated systolic hypertension in elderly subjects predisposes to the development of coronary artery disease, myocardial infarction, heart failure, cardiovascular events, stroke and cardiovascular mortality. Whether pharmacologic management of isolated systolic hypertension in the elderly is justified or not has not received attention until the recent years. In this era of the practice of evidence based medicine it is important to review the results of clinical trials about the management of isolated systolic hypertension involving thousands of elderly patients. The main trials and their results will be presented. These demonstrate a 17 per cent reduction in total mortality, 25 per cent reduction in cardiovascular mortality, 37 per cent reduction in stroke and a 25 per cent reduction in myocardial infarction for those patients under pharmacologic treatment.