Improved outcomes with antihypertensive medication in the elderly with isolated systolic hypertension

isolated systolic hypertension affects over 15% of all individuals aged > 6 0 years. In the elderly, systolic hypertension is a major modifiable cardio vascular risk factor. Systolic blood pressure (SBP) is associated with high er risk of an adverse outcome. whereas diastolic blood pressure (DBP) is in versely correlated with total mortality, independent of SEP, highlighting t he role of pulse pressure as a risk factor. Three placebo-controlled outcome trials on antihypertensive drug treatment in older patients with isolated systolic hypertension have been published: the Systolic Hypertension in the Elderly Program (SHEP), the Systolic Hyper tension in Europe (Syst-Eur) Trial and the Systolic Hypertension in China ( Syst-China) Trial. These 3 trials demonstrated the benefit of antihypertens ive drug treatment. A meta-analysis was performed by pooling the patients f rom these 3 trials with a subset of patients with isolated systolic hyperte nsion from 5 other trials in the elderly. The pooled results of 15 693 olde r patients with isolated systolic hyper tension prove that antihypertensive drug treatment is justified if on repeated clinic measurements SEP is 160m m Hg or higher.