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Isolated Systolic Hypertension

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Isolated Systolic Hypertension

  • See Also
  1. Hypertension
  2. Hypertension Causes
  3. Hypertension Evaluation
  4. Hypertension Evaluation History
  5. Evaluation Exam
  6. Hypertension Evaluation Labs
  7. Hypertension Management
  8. Hypertension Risk Stratification
  9. Resistant Hypertension
  10. Antihypertensive Selection
  11. Hypertension Management for Specific Comorbid Diseases
  12. Hypertension Management for Specific Populations
  13. Hypertension Management for Specific Emergencies
  14. Hypertension in Children
  15. Hypertension in Infants
  16. Hypertension in Pregnancy
  17. Hypertension in Athletes
  18. Hypertension in the Elderly
  • Epidemiology
  1. Most common type of Hypertension in adults
  • Criteria
  1. Systolic Blood Pressure: >140 mmHg (previously >160)
  2. Diastolic Blood Pressure: <90 mmHg
  1. General
    1. Systolic pressure predicts risk better than diastolic
    2. Wide Pulse Pressure best predicts Cardiovascular Risk
  2. Adverse Effects
    1. Doubles all cause mortality
    2. Triples cardiovascular mortality
    3. Increases cardiovascular morbidity 2.5 fold
  • Management
  1. Use lower Antihypertensive dosages
  2. Diuretics are first Choice Medication
    1. Even better benefit in Diabetes Mellitus with ISH
    2. Study of 4736 type II diabetics
      1. Lower Incidence of cardiac events
        1. Lower Incidence of Cerebrovascular Accidents
        2. Lower Incidence of Myocardial Infarction
      2. Reference
        1. Curb (1996) JAMA 276: 1886-92 [PubMed]
  3. Other Medications
    1. Dihydropyridine Calcium Channel Blocker
    2. Long Acting Nitroglycerin
    3. ACE Inhibitor
    4. Labetalol