High Blood Pressure
Management Of Hypertension
Despite the evidence that treatment is beneficial in terms of reducing morbidity and mortality, hypertension is still poorly controlled in elderly persons. Both in the United States and in Europe, less than 30 percent of patients on hypertensive drugs attain the JNC-VI goal blood pressure (<140 and <90 mmHg) (JNC-VI; Burt et al.). Achieving the goal is relatively easy for diastolic blood pressure, but much harder for systolic blood pressure. Moreover, the new indication of pulse pressure as the most powerful risk factor must now lead doctors to consider systolic rather than diastolic blood pressure when determining treatment goals. Consequently, the development of drugs that lower systolic blood pressure more effectively should be promoted (Staessen et al., 2000). Blacher et al. have emphasized the need for randomized trials with anti-hypertensive drugs that act differently on the pulsatile component of blood pressure. These authors suggested that vasopeptidase inhibitors and nitric oxide donors might increase the distensilibility of large arteries and reduce pulse pressure.
ANNE-SOPHIE RIGAUD
See also HEART DISEASE; STROKE; VASCULAR DISEASE.
BIBLIOGRAPHY
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Additional topics
Medicine EncyclopediaAging Healthy - Part 2High Blood Pressure - Definition Of Hypertension, Blood Pressure Changes And Hypertension, Risk Of Hypertension, Benefits Of Antihypertensive Therapy - Nonpharmacologic interventions