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Review: isolated systolic hypertension increases mortality and morbidity in elderly people and should be treated

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 QUESTIONS: In elderly people, what are the risks associated with isolated systolic hypertension (≥160 mm Hg with diastolic blood pressure [BP] <95 mm Hg), and what is the magnitude of the benefit associated with treatment?

Data sources

Studies were identified from 10 published overviews and 2 reports from trialist collaborations.

Study selection

Controlled trials were selected if elderly people with isolated systolic hypertension were enrolled. Trials were excluded if all the study participants had comorbid conditions, such as stroke; if specialised care was compared with routine antihypertensive agents; and if the study was a preliminary evaluation for a larger study.

Data extraction

Data were extracted on study quality, patient characteristics, antihypertensive treatment, duration and length of follow up, and outcomes (all cause and cardiovascular mortality, cardiovascular complications, all strokes, and all …

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  • Source of funding: not stated.

  • For correspondence: Dr J A Staessen, Studie-coördinatiecentrum, Laboratorium Hypertensie, Campus Gasthuisberg, Gebouw Onderwijs en Navorsing, Herestraat 49, B-3000 Leuven, Belgium. Fax +32 16 347106.