The American Journal of Medicine
Volume 121, Issue 3 , Pages 179-184.e3 , March 2008

Systolic Hypertension in the Elderly: Addressing an Unmet Need

  • Daniel A. Duprez, MD, PhD

      Affiliations

    • Corresponding Author InformationRequests for reprints should be addressed to Daniel A. Duprez, MD, PhD, Department of Medicine, Cardiovascular Division, VCRC - Room 270, University of Minnesota, 420 Delaware St. SE, MMC 508, Minneapolis, MN 55455.

References 

  1. Franklin SS, Jacobs MJ, Wong ND, et al. Predominance of isolated systolic hypertension among middle-aged and elderly US hypertensives: analysis based on National Health and Nutrition Examination Survey (NHANES) III. Hypertension. 2001;37:869–874
  2. Hajjar I, Kotchen TA. Trends in prevalence, awareness, treatment, and control of hypertension in the United States, 1988-2000. JAMA. 2003;290:199–206
  3. Fields LE, Burt VL, Cutler JA, et al. The burden of adult hypertension in the United States 1999 to 2000: a rising tide. Hypertension. 2004;44:398–404
  4. Crimmins EM, Alley D, Reynolds SL, et al. Changes in biological markers of health: older Americans in the 1990s. J Gerontol A Biol Sci Med Sci. 2005;60:1409–1413
  5. Pepe S, Lakatta EG. Aging hearts and vessels: masters of adaptation and survival. Cardiovasc Res. 2005;66:190–193
  6. O’Rourke MF, Safar ME. Relationship between aortic stiffening and microvascular disease in brain and kidney: cause and logic of therapy. Hypertension. 2005;46:200–204
  7. Lewington S, Clarke R, Qizilbash N, et al. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet. 2002;360:1903–1913
  8. Duprez DA. Role of the renin-angiotensin-aldosterone system in vascular remodeling and inflammation: a clinical review. J Hypertens. 2006;24:983–991
  9. Dahlof B, Devereux RB, Kjeldsen SE, et al. Cardiovascular morbidity and mortality in the Losartan Intervention For Endpoint reduction in hypertension study (LIFE): a randomised trial against atenolol. Lancet. 2002;359:995–1003
  10. Devereux RB, Palmieri V, Sharpe N, et al. Effects of once-daily angiotensin-converting enzyme inhibition and calcium channel blockade-based antihypertensive treatment regimens on left ventricular hypertrophy and diastolic filling in hypertension: the Prospective Randomized Enalapril Study Evaluating Regression of Ventricular Enlargement (PRESERVE) trial. Circulation. 2001;104:1248–1254
  11. Jafar TH, Schmid CH, Landa M, et al. Angiotensin-converting enzyme inhibitors and progression of nondiabetic renal disease: a meta-analysis of patient-level data. Ann Intern Med. 2001;135:73–87
  12. Vogt L, Navis G, Koster J, et al. The angiotensin II receptor antagonist telmisartan reduces urinary albumin excretion in patients with isolated systolic hypertension: results of a randomized, double-blind, placebo-controlled trial. J Hypertens. 2005;23:2055–2061
  13. Chobanian AV, Bakris GL, Black HR, et al. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA. 2003;289:2560–2572
  14. SHEP Cooperative Research Group. Prevention of stroke by antihypertensive drug treatment in older persons with isolated systolic hypertension (Final results of the Systolic Hypertension in the Elderly Program (SHEP)). JAMA. 1991;265:3255–3264
  15. Kostis JB, Wilson AC, Freudenberger RS, et al. Long-term effect of diuretic-based therapy on fatal outcomes in subjects with isolated systolic hypertension with and without diabetes. Am J Cardiol. 2005;95:29–35
  16. Sutton-Tyrrell K, Wildman R, Newman A, Kuller LH. Extent of cardiovascular risk reduction associated with treatment of isolated systolic hypertension. Arch Intern Med. 2003;163:2728–2731
  17. Staessen JA, Fagard R, Thijs L, et al. Randomised double-blind comparison of placebo and active treatment for older patients with isolated systolic hypertension. Lancet. 1997;350:757–764
  18. Systolic Hypertension in China (Syst-China) Collaborative GroupLiu L, Wang JG, Gong L, et al. Comparison of active treatment and placebo in older Chinese patients with isolated systolic hypertension. J Hypertens. 1998;16:1823–1829
  19. Staessen JA, Gasowski J, Wang JG, et al. Risks of untreated and treated isolated systolic hypertension in the elderly: meta-analysis of outcome trials. Lancet. 2000;355:865–872
  20. Kjeldsen SE, Dahlof B, Devereux RB, et al. Effects of losartan on cardiovascular morbidity and mortality in patients with isolated systolic hypertension and left ventricular hypertrophy: a Losartan Intervention for Endpoint Reduction (LIFE) substudy. JAMA. 2002;288:1491–1498
  21. Lithell H, Hansson L, Skoog I, et al. The Study on Cognition and Prognosis in the Elderly (SCOPE): principal results of a randomized double-blind intervention trial. J Hypertens. 2003;21:875–886
  22. Malacco E, Mancia G, Rappelli A, et al. Treatment of isolated systolic hypertension: the SHELL study results. Blood Press. 2003;12:160–167
  23. Mancia G, Ruilope LM, Palmer CR, et al. Effects of nifedipine GITS and diuretics in isolated systolic hypertension—a subanalysis of the INSIGHT study. Blood Press. 2004;13:310–315
  24. Malacco E, Vari N, Capuano V, et al. A randomized, double-blind, active-controlled, parallel-group comparison of valsartan and amlodipine in the treatment of isolated systolic hypertension in elderly patients: the Val-Syst study. Clin Ther. 2003;25:2765–2780
  25. London G, Schmieder R, Calvo C, Asmar R. Indapamide SR versus candesartan and amlodipine in hypertension: the X-CELLENT Study. Am J Hypertens. 2006;19:113–121
  26. Duprez DA, Cohn JN. Monitoring vascular health beyond blood pressure. Curr Hypertens Rep. 2006;8:287–291
  27. Duprez DA, Somasundaram PE, Sigurdsson G, et al. Relationship between C-reactive protein and arterial stiffness in an asymptomatic population. J Hum Hypertens. 2005;19:515–519
  28. Williams B, Lacy PS, Thom SM, et al. Differential impact of blood pressure-lowering drugs on central aortic pressure and clinical outcomes: principal results of the Conduit Artery Function Evaluation (CAFE) study. Circulation. 2006;113:1213–1225
  29. Azizi M, Webb R, Nussberger J, Hollenberg NK. Renin inhibition with aliskiren: where are we now, and where are we going?. J Hypertens. 2006;24:243–256
  30. Stanton A, Jensen C, Nussberger J, O’Brien E. Blood pressure lowering in essential hypertension with an oral renin inhibitor, aliskiren. Hypertension. 2003;42:1137–1143
  31. Oh B-H, Mitchell J, Herron JR, et al. Aliskiren, an oral renin inhibitor, provides dose-dependent efficacy and sustained 24-hour blood pressure control in patients with hypertension. J Am Coll Cardiol. 2007;49:1157–1163
  32. Oparil S, Yarows SA, Patel S, et al. Antihypertensive efficacy and safety of dual renin system intervention with aliskiren, an oral direct renin inhibitor, and valsartan: a randomized, double-blind comparison versus monotherapy. Lancet. 2007;370:221–229

PII: S0002-9343(07)01098-4

doi: 10.1016/j.amjmed.2007.10.027

The American Journal of Medicine
Volume 121, Issue 3 , Pages 179-184.e3 , March 2008

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