Hypertension Blog

Increased systolic blood pressure used to be considered a normal part of aging. An old rule stated that 100 mm Hg plus the patient’s age was tolerable. Isolated systolic hypertension wasn’t a treated condition. However, the results of the Systolic Hypertension in the Elderly Program (SHEP) study changed this way of thinking.

The SHEP study, a double-blind clinical trial, used low doses of chlorthalidone and atenolol to treat systolic hypertension. The participants’ blood pressures were then monitored for 4 to 5 years, after which the researchers found a 36% decrease in cerebrovascular accidents, a 25% decrease in coronary artery disease, and a 54% decrease in left ventricular heart failure in the patients who received the chlorthalidone and atenolol. Similar studies in Sweden and the United Kingdom later confirmed these findings.

Currently, the Fifth Report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure stresses the importance of systolic blood pressure in evaluating hypertension. Particularly for middle-aged and older patients, systolic hypertension increases the risk of cardiovascular disease, even when diastolic blood pressure is normal.