A COMPARATIVE ASSESSMENT OF THE EFFICACY OF VARIOUS ANTIHYPERTENSIVE DRUGS ON ISOLATED SYSTOLIC BLOOD PRESSURE IN ELDERLY.
Sana Rehman, *Razi Ahmad and Anwar Habib
ABSTRACT
Isolated systolic hypertension (ISH), is defined as an elevation in systolic pressure but normal diastolic pressure, and was originally considered part of aging like essential hypertension. Patients with isolated systolic hypertension are at substantially increased risk for stroke, coronary heart disease and congestive heart failure, elderly population is at increased risk Isolated systolic hypertension is a major problem in the elderly population, The prevalence and severity of the hypertension are strongly associated with the advancing age. Women have lower systolic blood pressure levels than men during early adulthood, however, after menopause blood pressure increases in women to levels even higher than in men. Uncontrolled or poorly controlled systolic hypertension is a major risk factor for cardiovascular morbidity and mortality in the elderly population. Proper control of isolated systolic hypertension by using appropriate medicine and proper care may improve the quality of life and productivity of the elderly population. Most of the drug used for the treatment of hypertension affect both systolic and diastolic blood pressure. In elderly population a 10mm Hg increase in pulse pressure increases the risk of cardiovascular complication and mortality by nearly 20%. The aim of the present study was to find out drug or combination of drugs that is most appropriate in controlling systolic blood pressure with adequate maintenance of pulse pressure and we found that angiotensin receptor blocker (Telmisartan), as single drug therapy, calcium channel blocker (amlodipine) in two drug combination therapy and calcium channel blocker in combination of ARB and hydrochlorothiazide provided appropriate control of systolic blood pressure and pulse pressure, further study is needed to establish their long-term morbidity and mortality profile.
Keywords: isolated systolic hypertension, Elderly, antihypertensive.
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