Current treatment guidelines emphasize the need to treat hypertension among people with multiple risk factors, including such conditions as high cholesterol, smoking, and being overweight. These are the individuals who have a greater chance of suffering a cardiovascular event such as heart attack or stroke. A team of American and Italian researchers investigated whether those guidelines were also appropriate for older patients with isolated systolic hypertension.

A person has isolated systolic hypertension when the top number in the BP reading is higher than 140 mmHg, while the bottom number is less than 90. It occurs with greater frequency as people age. The importance of isolated systolic hypertension as a risk factor has only recently been recognized, and many doctors are still reluctant to treat it.

In this study, researchers evaluated data from more than 4,000 people who took part in a large study, the Systolic Hypertension in the Elderly Program. All had elevated systolic blood pressure and a range of other risk factors for cardiovascular disease. Most of them did not have cardiovascular disease at the beginning of the study. Over the 4.5 years of follow-up, those who received no treatment had a higher rate of cardiovascular events. However, those who did receive treatment were protected from cardiovascular events regardless of their risk.

The researchers concluded that older people with systolic hypertension and other risk factors are prime candidates for antihypertensive treatment. They found that treatment of systolic hypertension is most effective in older patients with other risk factors.

Related information: Treatment | Risk factors