The role of systolic blood pressure in determining risk for cardiovascular disease

Abstract

Hypertension increases in prevalence with advancing age and is a leading cause of morbidity and mortality from cardiovascular disease. Patients with hypertension are at increased risk for the development of myocardial infarction, stroke, and congestive heart failure compared with their normotensive counterparts. Early hypertension intervention trials in patients with diastolic hypertension documented the benefits of blood pressure control in reducing the risk for cardiovascular disease events. In recent years, several trials have demonstrated the benefits of treating older patients with isolated systolic hypertension. Consequently, hypertension guidelines have evolved to reflect the important role of systolic blood pressure in determining hypertension status and have devoted much attention to isolated systolic hypertension as a distinct blood pressure category. These data have important implications for the elderly, in whom isolated systolic hypertension is the most common form of high blood pressure; in addition, the absolute risk of cardiovascular disease is higher in older than in younger persons. Since the number of older persons in developed countries is increasing, hypertension has become a growing public health concern.