Isolated systolic hypertension in the elderly

Isolated systolic hypertension is common in the elderly and is closely linked to cerebrovascular events and acute coronary events. Large randomized control trials have shown that treating isolated systolic hypertension decreased cardiovascular morbidity and mortality. Thiazide diuretics and dihydropyridine calcium antagonists are the primary agents used in these trials, supplemented with β blockers or angiotensin-converting enzyme inhibitors as needed. Lifestyle modification and pharmacologic treatment are the main modalities for treating isolated systolic hypertension in the elderly. However, the morbidity and mortality benefit of treating isolated systolic hypertension in the very old (individuals above the age of 80) remains to be established.