American Heart Journal
Volume 149, Issue 5 , Pages 769-775 , May 2005

Systolic hypertension: An overview

  • Todd F. Griffith, MD

      Affiliations

    • Duke Institute of Renal Outcomes Research and Health Policy, Department of Medicine, Duke University Medical Center, Durham, NC
    • Corresponding Author InformationReprints not available from authors.
  • ,
  • Preston S. Klassen, MD

      Affiliations

    • Duke Institute of Renal Outcomes Research and Health Policy, Department of Medicine, Duke University Medical Center, Durham, NC
    • Amgen Inc, Thousand Oaks, Calif
  • ,
  • Stanley S. Franklin, MD

      Affiliations

    • Heart Disease Prevention Program, University of California, Irvine, Calif

Received 25 January 2005 ,Accepted 25 January 2005.

References 

  1. The Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Arch Intern Med. 1997;157:2413–2446
  2. Burt VL, Whelton P, Roccella EJ. Prevalence of hypertension in the US adult population. Results from the Third National Health and Nutrition Examination Survey, 1988-1991. Hypertension. 1995;25:305–313
  3. Vasan RS, Beiser A, Seshadri S. Residual lifetime risk for developing hypertension in middle-aged women and men: the Framingham Heart Study. JAMA. 2002;287:1003–1010
  4. Vasan RS, Larson MG, Leip EP. Assessment of frequency of progression to hypertension in non-hypertensive participants in the Framingham Heart Study: a cohort study. Lancet. 2001;358:1682–1686
  5. Curb JD, Borhani NO, Entwisle G. Isolated systolic hypertension in 14 communities. Am J Epidemiol. 1985;121:362–370
  6. Franklin SS, Jacobs MJ, Wong ND. Predominance of isolated systolic hypertension among middle-aged and elderly US hypertensives: analysis based on National Health and Nutrition Examination Survey (NHANES) III. Hypertension. 2001;37:869–874
  7. Franklin SS, Gustin WT, Wong ND. Hemodynamic patterns of age-related changes in blood pressure. The Framingham Heart Study. Circulation. 1997;96:308–315
  8. Hyman DJ, Pavlik VN. Characteristics of patients with uncontrolled hypertension in the United States. N Engl J Med. 2001;345:479–486
  9. Gubner RS. Systolic hypertension: a pathogenetic entity. Am J Cardiol. 1962;9:773–776
  10. US Department of Health, Education, and Welfare . The Framingham study: an epidemiological investigation of cardiovascular disease. Washington (DC): US Department of Health, Education, and Welfare; 1968;
  11. Colandrea MA, Friedman GD, Nichaman MZ. Systolic hypertension in the elderly. An epidemiologic assessment. Circulation. 1970;41:239–245
  12. Lew EA. High blood pressure, other risk factors and longevity: the insurance viewpoint. Am J Med. 1973;55:281–294
  13. Shekelle RB, Ostfeld AM, Klawans HL. Hypertension and risk of stroke in an elderly population. Stroke. 1974;5:71–75
  14. Garland C, Barrett-Connor E, Suarez L. Isolated systolic hypertension and mortality after age 60 years. A prospective population-based study. Am J Epidemiol. 1983;118:365–376
  15. Tuomilehto J, Salonen JT, Nissinen A. Isolated systolic hypertension and its relationship to the risk of myocardial infarction, cerebrovascular disease and death in a middle-aged population. Eur Heart J. 1984;5:739–744
  16. Kannel WB, Gordon T, Schwartz MJ. Systolic versus diastolic blood pressure and risk of coronary heart disease. The Framingham Study. Am J Cardiol. 1971;27:335–346
  17. Kannel WB, Wolf PA, McGee DL. Systolic blood pressure, arterial rigidity, and risk of stroke. The Framingham Study. JAMA. 1981;245:1225–1229
  18. Rutan GH, Kuller LH, Neaton JD. Mortality associated with diastolic hypertension and isolated systolic hypertension among men screened for the Multiple Risk Factor Intervention Trial. Circulation. 1988;77:504–514
  19. Stamler J, Neaton JD, Wentworth DN. Blood pressure (systolic and diastolic) and risk of fatal coronary heart disease. Hypertension. 1989;13:I2–I12
  20. Neaton JD, Wentworth D. Serum cholesterol, blood pressure, cigarette smoking, and death from coronary heart disease. Overall findings and differences by age for 316, 099 white men. Multiple Risk Factor Intervention Trial Research Group. Arch Intern Med. 1992;152:56–64
  21. Alli C, Avanzini F, Bettelli G. The long-term prognostic significance of repeated blood pressure measurements in the elderly: SPAA (Studio sulla Pressione Arteriosa nell'Anziano) 10-year follow-up. Arch Intern Med. 1999;159:1205–1212
  22. Stamler J, Stamler R, Neaton JD. Blood pressure, systolic and diastolic, and cardiovascular risks. US population data. Arch Intern Med. 1993;153:598–615
  23. Strandberg TE, Salomaa VV, Vanhanen HT. Isolated diastolic hypertension, pulse pressure, and mean arterial pressure as predictors of mortality during a follow-up of up to 32 years. J Hypertens. 2002;20:399–404
  24. Benetos A, Thomas F, Bean K. Prognostic value of systolic and diastolic blood pressure in treated hypertensive men. Arch Intern Med. 2002;162:577–581
  25. Lloyd-Jones DM, Evans JC, Larson MG. Differential impact of systolic and diastolic blood pressure level on JNC-VI staging. Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension. 1999;34:381–385
  26. Chae CU, Pfeffer MA, Glynn RJ. Increased pulse pressure and risk of heart failure in the elderly. JAMA. 1999;281:634–639
  27. Vaccarino V, Holford TR, Krumholz HM. Pulse pressure and risk for myocardial infarction and heart failure in the elderly. J Am Coll Cardiol. 2000;36:130–138
  28. Kostis JB, Lawrence-Nelson J, Ranjan R. Association of increased pulse pressure with the development of heart failure in SHEP. Systolic Hypertension in the Elderly (SHEP) Cooperative Research Group. Am J Hypertens. 2001;14:798–803
  29. Franklin SS, Khan SA, Wong ND. Is pulse pressure useful in predicting risk for coronary heart disease? The Framingham Heart Study. Circulation. 1999;100:354–360
  30. Domanski MJ, Davis BR, Pfeffer MA. Isolated systolic hypertension: prognostic information provided by pulse pressure. Hypertension. 1999;34:375–380
  31. Blacher J, Staessen JA, Girerd X. Pulse pressure not mean pressure determines cardiovascular risk in older hypertensive patients. Arch Intern Med. 2000;160:1085–1089
  32. Glynn RJ, Chae CU, Guralnik JM. Pulse pressure and mortality in older people. Arch Intern Med. 2000;160:2765–2772
  33. Antikainen RL, Jousilahti P, Vanhanen H. Excess mortality associated with increased pulse pressure among middle-aged men and women is explained by high systolic blood pressure. J Hypertens. 2000;18:417–423
  34. Domanski M, Mitchell G, Pfeffer M. Pulse pressure and cardiovascular disease-related mortality: follow-up study of the Multiple Risk Factor Intervention Trial (MRFIT). JAMA. 2002;287:2677–2683
  35. Franklin SS, Larson MG, Khan SA. Does the relation of blood pressure to coronary heart disease risk change with aging? The Framingham Heart Study. Circulation. 2001;103:1245–1249
  36. The Systolic Hypertension in the Elderly Program (SHEP) Cooperative Research Group. Rationale and design of a randomized clinical trial on prevention of stroke in isolated systolic hypertension. J Clin Epidemiol. 1988;41:1197–1208
  37. SHEP Cooperative Research Group. Prevention of stroke by antihypertensive drug treatment in older persons with isolated systolic hypertension. Final results of the Systolic Hypertension in the Elderly Program (SHEP). JAMA. 1991;265:3255–3264
  38. Sackett DL, Haynes RB, Guyatt GH, et al. Clinical epidemiology: a basic science for clinical medicine. Boston (Mass): Little, Brown and Company; 1991;441 pp
  39. Perry HM, Davis BR, Price TR. Effect of treating isolated systolic hypertension on the risk of developing various types and subtypes of stroke: the Systolic Hypertension in the Elderly Program (SHEP). JAMA. 2000;284:465–471
  40. Kostis JB, Davis BR, Cutler J. Prevention of heart failure by antihypertensive drug treatment in older persons with isolated systolic hypertension. SHEP Cooperative Research Group. JAMA. 1997;278:212–216
  41. Curb JD, Pressel SL, Cutler JA. Effect of diuretic-based antihypertensive treatment on cardiovascular disease risk in older diabetic patients with isolated systolic hypertension. Systolic Hypertension in the Elderly Program Cooperative Research Group. JAMA. 1996;276:1886–1892
  42. Ferrucci L, Furberg CD, Penninx BW. Treatment of isolated systolic hypertension is most effective in older patients with high-risk profile. Circulation. 2001;104:1923–1926
  43. Staessen JA, Fagard R, Thijs L. Randomised double-blind comparison of placebo and active treatment for older patients with isolated systolic hypertension. The Systolic Hypertension in Europe (Syst-Eur) Trial Investigators. Lancet. 1997;350:757–764
  44. Liu L, Wang JG, Gong L. Comparison of active treatment and placebo in older Chinese patients with isolated systolic hypertension. Systolic Hypertension in China (Syst-China) Collaborative Group. J Hypertens. 1998;16:1823–1829
  45. Staessen JA, Gasowski J, Wangm JG. Risks of untreated and treated isolated systolic hypertension in the elderly: meta-analysis of outcome trials. Lancet. 2000;355:865–872
  46. Koch-Weser J. Correlation of pathophysiology and pharmacotherapy in primary hypertension. Am J Cardiol. 1973;32:499–510
  47. Mourad JJ, Blacher J, Blin P. Conventional antihypertensive drug therapy does not prevent the increase of pulse pressure with age. Hypertension. 2001;38:958–961
  48. Gerdts E, Papademetriou V, Palmieri V. Correlates of pulse pressure reduction during antihypertensive treatment (losartan or atenolol) in hypertensive patients with electrocardiographic left ventricular hypertrophy (the LIFE study). Am J Cardiol. 2002;89:399–402
  49. Asmar RG, London GM, O'Rourke ME. Improvement in blood pressure, arterial stiffness and wave reflections with a very-low-dose perindopril/indapamide combination in hypertensive patient: a comparison with atenolol. Hypertension. 2001;38:922–926
  50. Cushman WC, Materson BJ, Williams DW. Pulse pressure changes with six classes of antihypertensive agents in a randomized, controlled trial. Hypertension. 2001;38:953–957
  51. Mitchell GF, Izzo JL, Lacourciere Y. Omapatrilat reduces pulse pressure and proximal aortic stiffness in patients with systolic hypertension: results of the conduit hemodynamics of omapatrilat international research study. Circulation. 2002;105:2955–2961
  52. Weber MA. Vasopeptidase inhibitors. Lancet. 2001;358:1525–1532
  53. Ferrier KE, Muhlmann MH, Baguet JP. Intensive cholesterol reduction lowers blood pressure and large artery stiffness in isolated systolic hypertension. J Am Coll Cardiol. 2002;39:1020–1025
  54. Kass DA, Shapiro EP, Kawaguchi M. Improved arterial compliance by a novel advanced glycation end-product crosslink breaker. Circulation. 2001;104:1464–1470
  55. Moore TJ, Conlin PR, Ard J. DASH (Dietary Approaches to Stop Hypertension) diet is effective treatment for stage 1 isolated systolic hypertension. Hypertension. 2001;38:155–158
  56. Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic: the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). JAMA. 2002;288:2981–2997
  57. ALLHAT Collaborative Research Group. Major cardiovascular events in hypertensive patients randomized to doxazosin vs chlorthalidone: the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). JAMA. 2000;283:1967–1975
  58. Hansson L, Lindholm LH, Ekbom T. Randomised trial of old and new antihypertensive drugs in elderly patients: cardiovascular mortality and morbidity in the Swedish Trial in Old Patients with Hypertension–2 study. Lancet. 1999;354:1751–1756
  59. Lloyd-Jones DM, Evans JC, Larson MG. Differential control of systolic and diastolic blood pressure: factors associated with lack of blood pressure control in the community. Hypertension. 2000;36:594–599
  60. Whyte JL, Lapuerta P, L'Italien GJ. The challenge of controlling systolic blood pressure: data from the National Health and Nutrition Examination Survey (NHANES III), 1988-1994. J Clin Hypertens. 2001;3:211–216
  61. Berlowitz DR, Ash AS, Hickey EC. Inadequate management of blood pressure in a hypertensive population. N Engl J Med. 1998;339:1957–1963
  62. Alexander M, Tekawa I, Hunkeler E. Evaluating hypertension control in a managed care setting. Arch Intern Med. 1999;159:2673–2677
  63. Davis BR, Cutler JA, Gordon DJ. Rationale and design for the Antihypertensive and Lipid Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). ALLHAT Research Group. Am J Hypertens. 1996;9:342–360
  64. Appel LJ. The verdict from ALLHAT-thiazide diuretics are the preferred initial therapy for hypertension. JAMA. 2002;288:3039–3042
  65. Wright JT, Agodoa L, Contreras G. Successful blood pressure control in the African American study of kidney disease and hypertension. Arch Intern Med. 2002;162:1636–1643
  66. Bakris GL. Maximizing cardiorenal benefit in the management of hypertension: achieve blood pressure goals. J Clin Hypertens. 1999;1:141–147
  67. Hyman DJ, Pavlik VN. Self-reported hypertension treatment practices among primary care physicians: blood pressure thresholds, drug choices, and the role of guidelines and evidence-based medicine. Arch Intern Med. 2000;160:2281–2286
  68. Borenstein J, Whyte JL, Badamgarav E. Physician practice patterns in the treatment of isolated systolic hypertension in a primary care setting. J Clin Hypertens. 2002;4:93–100
  69. Oliveria SA, Lapuerta P, McCarthy BD. Physician-related barriers to the effective management of uncontrolled hypertension. Arch Intern Med. 2002;162:413–420
  70. Lomas J, Anderson GM, Domnick-Pierre K. Do practice guidelines guide practice? The effect of a consensus statement on the practice of physicians. N Engl J Med. 1989;321:1306–1311
  71. Hemingway H, Crook AM, Feder G. Underuse of coronary revascularization procedures in patients considered appropriate candidates for revascularization. N Engl J Med. 2001;344:645–654
  72. Port S, Demer L, Jennrich R. Systolic blood pressure and mortality. Lancet. 2000;355:175–180
  73. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. In: Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA. 285:2001;p. 2486–2497
  74. Mann J, Julius S. The Valsartan Antihypertensive Long-term Use Evaluation (VALUE) trial of cardiovascular events in hypertension. In: Rationale and design. 7:Blood Press; 1998;p. 176–183

PII: S0002-8703(05)00108-0

doi: 10.1016/j.ahj.2005.01.037

American Heart Journal
Volume 149, Issue 5 , Pages 769-775 , May 2005