Isolated systolic hypertension and subclinical hypertension and subclinical cardiovascular disease in the elderly: initial findings from the cardiovascular health study

Article Abstract:

Many elderly individuals with isolated systolic hypertension (ISH) may have undiagnosed cardiovascular disease. ISH is a form of high blood pressure associated with the development of cardiovascular disease. Among 2,189 individuals over 65 years old, 195 (9%) were diagnosed with ISH and 596 (23%) were diagnosed with borderline ISH. Two to three times more of the individuals with ISH had experienced an unreported heart attack compared with those without ISH. Individuals with ISH or borderline ISH were more likely to have enlargement of the left ventricle of the heart or decreased cardiac diastolic function than those who did not. Patients with ISH were more likely to have thickening of the walls of the carotid artery than those without ISH. Elderly individuals with ISH or borderline ISH should undergo treatment for elevated blood pressure to prevent cardiovascular disease.

Aged, Elderly, Cardiovascular diseases, Statistics, Diseases

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Temporal patterns of antihypertensive medication use among older adults, 1989 through 1992: an effect of the major clinical trials on clinical practice?

Article Abstract:

Major clinical trials, which found that low-dose thiazide diuretics reduced the risk of stroke and coronary heart disease, influenced the use of the antihypertensive medicine for older adults in clinical practice, especially among women. The portion which began diuretic therapy rose from 35.9% to 47.5%, following the publication of the clinical trials. The number of patients beginning antihypertensive drug therapy were 157 for the first study period, 142 for the second, and 120 for the third. Among patients who were continuous users of hypertensive medicine, the use of beta-blockers and diuretics decreased over the study period of three years. The use of calcium channel blockers increased in each of the three study periods, however the rate of increase dropped between the first study period and the third.

Usage, Evaluation, Prevention, Coronary heart disease, Stroke (Disease), Stroke, Diuretics, Thiazides

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Recent trials in hypertension

Article Abstract:

Some of the design-choices made in the long-term trial of antihypertensive agents including placebo-controlled trials and the more recent active-comparison trials are reviewed. Earlier trials in hypertension recruited patients with diastolic blood pressure up to 129 mm Hg and compared active treatments, primarily high-dose diuretics, with placebo, which suggested that antihypertensive treatment reduced the risk of cardiovascular events in patients with high diastolic blood pressure.

United States, Science & research, Pharmaceutical Preparation Manufacturing, Pharmaceutical preparations, Blood Pressure Preparations, Research, Drug therapy

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