Isolated
systolic hypertension
Isolated systolic hypertension (ISH) is common in the elderly, affecting around 50% of people older than 70 years old. The Systolic Hypertension in the Elderly Program (SHEP) back in 1991 established that treating ISH reduced both strokes and ischaemic heart disease. Drugs such as thiazides were recommended as first line agents. This approach is contradicated by the 2011 NICE guidelines which recommends treating ISH in the same stepwise fashion as standard hypertension.
The 2011 NICE guidelines recommended treating isolated systolic
hypertension the same way as standard hypertension. In this age group calcium
channel blockers would be first-line.
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