Isolated Systolic Hypertension

Hypertension with elevated systolic and normal diastolic blood pressure. It is the most common subtype in the elderly and is related to VASCULAR STIFFNESS and ATHEROSCLEROTIC PLAQUE buildup.

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Networked: 1426 relevant articles (100 outcomes, 344 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Hypertension (High Blood Pressure)
2.	Isolated Systolic Hypertension
3.	Stroke (Strokes)
4.	Dementia (Dementias)
5.	Essential Hypertension

Experts

1.	Weber, Michael A: 21 articles (01/2021 - 02/2002)
2.	Bakris, George L: 18 articles (01/2018 - 07/2003)
3.	Dahlöf, Björn: 17 articles (01/2021 - 02/2002)
4.	Pitt, Bertram: 14 articles (01/2018 - 09/2004)
5.	Staessen, J A: 14 articles (07/2003 - 01/2000)
6.	Kjeldsen, Sverre E: 11 articles (10/2019 - 09/2002)
7.	Jamerson, Kenneth: 11 articles (04/2016 - 07/2006)
8.	Jamerson, Kenneth A: 10 articles (01/2021 - 07/2003)
9.	Izzo, Joseph L: 9 articles (06/2017 - 06/2002)
10.	Feldman, Ross D: 9 articles (01/2017 - 01/2004)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Isolated Systolic Hypertension:

1.	Antihypertensive Agents (Antihypertensives)IBA 04/01/1996 - "Surgical repair of coarctation in adults is an effective, low-risk procedure, which results in a significant improvement in systolic hypertension and a decreased requirement of antihypertensive medications." 01/01/2003 - "On the other hand, since current antihypertensive drugs are equally effective in lowering SBP and DBP and-or less effective in lowering SBP more than DBP, SBP is often uncontrolled in treated patients with isolated systolic hypertension or prevalent increase in SBP. " 05/01/1999 - "Several trials performed in elderly patients have demonstrated that antihypertensive drugs are effective in both systo-diastolic and isolated systolic hypertension, reducing the incidence of fatal and nonfatal cardiovascular events. " 01/01/2008 - "The radial tonometry method helped characterize aging change, identified spurious systolic hypertension of youth, and greater hemodynamic benefit of "new" over "old" antihypertensive drugs. " 02/01/2003 - "Currently available antihypertensive medications are less effective in controlling systolic hypertension."
2.	DiureticsIBA 01/01/1994 - "In the Systolic Hypertension in the Elderly Study, which primarily used diuretics, there was a significant reduction in LVH at 5 years.(ABSTRACT TRUNCATED AT 250 WORDS)" 12/01/2000 - "Cardiovascular benefits of treatment with low dose diuretics or beta-blockers are cleared for elderly subjects with either diastolic or isolated systolic hypertension. " 10/31/2019 - "Only patients with ABPM-confirmed uncontrolled hypertension (systolic ≥140 mmHg and/or diastolic ≥90mmHg despite maximal doses of ≥3 medications, including a diuretic) were included. " 05/01/2011 - "A cohort of 45 patients with resistant hypertension (systolic BP ≥160 mm Hg on ≥3 antihypertension drugs, including a diuretic) has been originally published. " 03/01/2002 - "SHEP evaluated the cognitive status effects of a diuretic-based treatment of isolated systolic hypertension versus placebo. "
3.	Hydrochlorothiazide (Esidrix)FDA LinkGeneric 01/01/2007 - "The authors conclude that an OM-based regimen, with or without HCTZ in conventional doses, is effective in controlling and normalizing BP in stage 2 systolic hypertension." 10/01/1991 - "We conclude that hydrochlorothiazide is effective and well tolerated in older patients with isolated systolic hypertension, many of whom may be effectively treated with 25 mg of hydrochlorothiazide once daily." 10/01/1991 - "In a double-blind randomized study, we evaluated the effects of 25 mg vs 50 mg of hydrochlorothiazide in 51 elderly patients (aged 68.9 +/- 7.0 years) with isolated systolic hypertension (blood pressure, 160 to 239 mm Hg systolic and less than 90 mm Hg diastolic). " 10/01/1991 - "III. Response of isolated systolic hypertension to various doses of hydrochlorothiazide: results of a Department of Veterans Affairs cooperative study. " 04/01/2012 - "Baseline PRA is not a useful guide to the BP responses of initial combination V/HCTZ in elderly individuals with systolic hypertension."
4.	Amlodipine (Norvasc)FDA LinkGeneric 04/01/2007 - "Subgroup analyses showed S-amlodipine to be effective and safe in elderly hypertensives and isolated systolic hypertension patients. " 09/01/2007 - "Distinct effects of amlodipine treatment on vascular elastocalcinosis and stiffness in a rat model of isolated systolic hypertension." 01/01/2003 - "The effect of amlodipine in reducing SBP was greater in elderly patients (age>or=60 years) and patients with author-defined isolated systolic hypertension. " 07/01/1993 - "[Amlodipine in isolated systolic hypertension in the aged]." 01/01/1991 - "Open evaluation of amlodipine in the monotherapeutic treatment of systolic hypertension in the elderly."
5.	EnalaprilFDA LinkGeneric 11/01/1992 - "The results of this study demonstrate that enalapril and verapamil are well tolerated and effective in the treatment of isolated systolic hypertension in the elderly." 01/01/2001 - "Eprosartan and enalapril were equally effective in reducing sitSBP and sitDBP in elderly patients with predominantly systolic hypertension. " 01/01/2019 - "To describe the efficacy of a stratified approach on automatic office blood pressure (BP), 24-hour ambulatory BP, and BP variability (BPV) in treatment-naïve patients with systolic hypertension using lercanidipine for stage 1 and lercanidipine/enalapril for stage 2. This was an open-label, prospective interventional study conducted in 22 general practices in South Africa. " 05/01/1993 - "1. The safety and efficacy of amlodipine and enalapril were compared in patients with isolated systolic hypertension (supine DBP < 95 mm Hg and supine SBP 160-200 mm Hg). " 11/01/1992 - "A prospective, investigator-blinded, randomized study was conducted to compare the efficacy and tolerability of enalapril and verapamil in the treatment of isolated systolic hypertension in elderly patients. "
6.	Valsartan (Vals)FDA Link 08/01/2000 - "Efficacy of valsartan in patients aged > or =65 years with systolic hypertension." 01/01/2017 - "We used data from the VALISH study (Valsartan in Elderly Isolated Systolic Hypertension) that recruited older adults (n=3035; mean age, 76 years) with systolic BP (SBP) of ≥160 mm Hg and diastolic BP of <90 mm Hg. " 08/01/2010 - "Target blood pressure for treatment of isolated systolic hypertension in the elderly: valsartan in elderly isolated systolic hypertension study." 09/01/2004 - "valsartan in elderly isolated systolic hypertension (VALISH) study: rationale and design." 01/01/2012 - "Eighty untreated patients with isolated systolic hypertension were randomized to valsartan 320 mg or to a non-RAAS regimen during 6 months. "
7.	Chlorthalidone (Chlortalidone)FDA LinkGeneric 12/01/1985 - "In a large feasibility trial, 551 men and women who had isolated systolic hypertension and were at least 60 years old received chlorthalidone (25 to 50 mg/day) or matching placebo as the step I drug. " 02/15/2014 - "We examined the effect of chlorthalidone-based stepped care on the competing risks of cardiovascular (CV) versus non-CV death in the Systolic Hypertension in the Elderly Program (SHEP). " 12/21/2011 - "Association between chlorthalidone treatment of systolic hypertension and long-term survival." 09/01/1994 - "The effect of chlorthalidone on ventricular ectopic activity in patients with isolated systolic hypertension. " 03/01/1986 - "The data suggest that most elderly patients with isolated systolic hypertension, regardless of the severity, could be treated effectively and safely with chlorthalidone 12.5 mg per day."
8.	Losartan (Cozaar)FDA LinkGeneric 10/01/2010 - "To compare the efficacy of two doses of losartan (LOS)⁄HCTZ combinations in patients with uncontrolled ambulatory systolic hypertension after six weeks of treatment with LOS 100 mg⁄HCTZ 25 mg (LOS100⁄HCTZ25). " 01/16/2003 - "[Losartan in isolated systolic hypertension--convincing results of a LIFE sub-group study]." 02/01/2015 - "However, there have been few reports discussing the effectiveness of Lo/HTCZ (losartan 50 mg/hydrochlorothizide 12.5 mg) in the 'real world' in the management of isolated systolic hypertension (ISH). " 02/01/2005 - "Recent evidence has demonstrated that losartan offers cardiovascular outcomes benefits in isolated systolic hypertension (ISH) associated with an excellent tolerability profile. " 03/01/2002 - "In patients with isolated systolic hypertension, a once-daily losartan-based treatment regimen significantly lowered SBP. "
9.	Angiotensin Receptor AntagonistsIBA 06/01/2010 - "Few data are available regarding the efficacy of angiotensin II receptor antagonists on systolic hypertension of the elderly. " 10/01/2004 - "New tools, old challenges: the emerging role of angiotensin receptor blockers in the treatment of the systolic hypertension epidemic." 12/01/2004 - "Therefore, an angiotensin receptor blocker-based treatment strategy appears to be an attractive and evidence-based approach for the management of systolic hypertension, the reduction of arterial stiffness and the prevention of cardiovascular disease." 06/01/2021 - "Information about the effects of angiotensin II receptor blocker (ARB) therapy on the hemodynamic and cardiac structure in patients with chronic aortic regurgitation (CAR) and isolated systolic hypertension (ISH) is limited. " 10/01/2010 - "Increasing the doses of both diuretics and angiotensin receptor blockers is beneficial in subjects with uncontrolled systolic hypertension."
10.	PerindoprilFDA LinkGeneric 10/04/2001 - "Placebo-controlled trials in a wide range of patients with hypertension, including the elderly, those with isolated systolic hypertension, and those with concomitant diseases such as hyperlipidemia, diabetes, cardiac arrhythmia, peripheral arterial occlusive disease, nephropathy with proteinuria, and chronic obstructive pulmonary disease, have shown that perindopril is highly effective in lowering both systolic and diastolic blood pressure (BP). " 01/01/2009 - "Replacing the previous ACE inhibitor with perindopril 5-10 mg/day resulted in decreases of 26.2 mmHg (from 162.6 + or - 15.6 to 136.4 + or - 14.6 mmHg [p < 0.001]) in systolic BP and of 12.6 mmHg (from 96.9 + or - 17.2 to 84.3 + or - 12.8 mmHg [p < 0.001]) in diastolic BP. Mean pulse pressure (PP) was reduced by 13.6 mmHg (from 65.7 to 52.1 mmHg) with greater decreases seen in patients aged >70 years or with isolated systolic hypertension. " 10/01/1999 - "The efficacy and safety of 12 weeks treatment with an oral fixed low-dose perindopril 2 mg + indapamide 0.625 mg (Per/Ind) combination in elderly and very elderly patients (65-85 years) with mild to moderate systolic and diastolic hypertension (SDH) or isolated systolic hypertension (ISH) were investigated vs placebo. " 08/01/1999 - "Once daily oral perindopril 2mg/indapamide 0.625mg normalised blood pressure (BP) in 83.6% of elderly patients with essential hypertension (diastolic BP was reduced to < or =90mm Hg) and 81.7% of those with isolated systolic hypertension (systolic BP was reduced to <160mm Hg) after approximately 1 year of treatment. " 05/01/2004 - "Significant antihypertensive effects of perindopril were also demonstrated in the special patient populations of elderly (>or=65 years), black, isolated systolic hypertension, patients with concomitant cardiovascular diseases, and patients nonresponsive to other ACEI therapy. "

Therapies and Procedures

1.	Therapeutics 03/01/1983 - "More data are needed to arrive at optimal treatment regimens and to examine the efficacy of therapy in pure systolic hypertension. " 05/01/2006 - "In this analysis, combination therapy was associated with significantly greater reductions in mean 24-hour BP, pulse pressure, and mean ambulatory BP during various time intervals compared with either monotherapy in the intent-to-treat population, in those with isolated and predominantly systolic hypertension, and in dippers and nondippers. " 02/01/2015 - "The Avoiding Cardiovascular Events Through Combination Therapy in Patients Living With Systolic Hypertension (ACCOMPLISH) trial showed that the combination of benazepril+amlodipine (B+A) is superior to benazepril+hydrochlorothiazide (B+H) in reducing CV events. " 05/01/2006 - "This study demonstrated that combination therapy is superior to monotherapy in older patients with stage 2 systolic hypertension and is well tolerated." 11/01/2005 - "Efficacy of combination therapy for systolic blood pressure in patients with severe systolic hypertension: the Systolic Evaluation of Lotrel Efficacy and Comparative Therapies (SELECT) study."
2.	Dietary Approaches To Stop Hypertension 08/01/2001 - "DASH (Dietary Approaches to Stop Hypertension) diet is effective treatment for stage 1 isolated systolic hypertension." 09/01/2019 - "We conducted a randomized, controlled, cross-over feeding trial to test RAAS-related mechanisms underlying the DASH diet in patients with isolated systolic hypertension. " 09/01/2015 - "We devised the Mediterranean-Dietary Approach to Systolic Hypertension (DASH) diet intervention for neurodegenerative delay (MIND) diet score that specifically captures dietary components shown to be neuroprotective and related it to change in cognition over an average 4.7 years among 960 participants of the Memory and Aging Project. " 03/01/2002 - "The Dietary Approaches to Stop Hypertension diet lowered systolic blood pressure in stage-1 isolated systolic hypertension." 01/25/2010 - "To compare the DASH diet alone or combined with a weight management program with usual diet controls among participants with prehypertension or stage 1 hypertension (systolic BP, 130-159 mm Hg; or diastolic BP, 85-99 mm Hg). "
3.	Blood Transfusion (Blood Transfusions) 11/01/1997 - "No adverse impacts on patient's vital signs were noted except 2 incidences of systolic hypertension and one episode of diastolic hypertension in the week 4. Subcutaneous injection of r-HuEPO at the dose of 150 u/kg tiw was safe and effective in increasing patient's hematocrit and RBC mass, and decreasing their blood transfusion requirement. " 07/01/2020 - " subsequent hospital course was complicated by renal failure requiring continuous renal replacement therapy, hypertension (systolic blood pressure ranging from 140 to 190 mm Hg), anemia requiring blood transfusions, thrombocytopenia, and pneumonia. "
4.	Subcutaneous Injections 11/01/1997 - "No adverse impacts on patient's vital signs were noted except 2 incidences of systolic hypertension and one episode of diastolic hypertension in the week 4. Subcutaneous injection of r-HuEPO at the dose of 150 u/kg tiw was safe and effective in increasing patient's hematocrit and RBC mass, and decreasing their blood transfusion requirement. "
5.	Drug Therapy (Chemotherapy) 12/01/1986 - "SHEP-Pilot Study, a randomized, double-blind, placebo-controlled trial of drug therapy for isolated systolic hypertension, followed 551 participants aged 60 years or more with untreated blood pressures of greater than or equal to 160/less than 90 mmHg for an average of 34 months. " 01/01/2021 - "The lack of consistent excess in CAC or CVD suggests that emphasis on healthy lifestyle rather than drug therapy is sufficient among the millions of middle-aged or older adults who now meet the 2017 ACC/AHA criteria for IDH, though they require follow-up for incident systolic hypertension. " 02/01/2006 - "In uncomplicated stage I hypertension (systolic BP of 140 to 159 mm Hg or diastolic BP of 90 to 99 mm Hg), dietary changes serve as initial treatment before drug therapy. " 12/01/2005 - "To determine the therapeutic status and rate of reaching target blood pressure in elderly isolated systolic hypertension (EISH) patients who were hospitalized and to discuss the rationality of the drug therapy. " 08/01/1987 - "Risk of isolated systolic hypertension is sufficient to justify cautiously administering drug therapy if nonpharmacologic therapy fails to bring the systolic pressure less than 160 mm Hg, even though controlled studies have not been completed to prove efficacy. "