-
Views
-
Cite
Cite
Bernard Waeber, Jean-Jacques Mourad, Targeting Systolic Blood Pressure: The Key to Controlling Combined Systolic/Diastolic Hypertension, American Journal of Hypertension, Volume 19, Issue 9, September 2006, Pages 985–986, https://doi.org/10.1016/j.amjhyper.2006.03.012
Close - Share Icon Share
Extract
To the Editor: Hypertension is a strong and independent risk factor for cardiovascular morbidity and mortality. Treatment effectively prevents major complications such as stroke and myocardial infarction. Until recently worldwide practice was to prioritize the control of diastolic blood pressure (BP), as most interventional trials showing the benefit of drug therapy have taken diastolic BP as both an inclusion criterion and a target. However, the epidemiologic evidence indicates that systolic BP is the better predictor of cardiovascular morbidity and mortality.1 Systolic control also provides significant protection against cardiovascular complications.2 Large trials in elderly patients with isolated systolic hypertension prompted the formulation of international guidelines recommending the normalization of both systolic and diastolic BP,3,4 currently to less than 140/90 mm Hg in all hypertensive patients, and lower still in the presence of concomitant diabetes or chronic renal disease. Notably, the excess risk of cardiovascular mortality found in treated hypertensive as compared with untreated normotensive individuals of the same age appears to be due mainly to persistently high systolic BP levels under treatment.5
