Does therapy lowering diastolic pressure affect mortality in the U.S. population 65 years and older with elevated systolic pressure?
Lowering diastolic pressure in elderly patients with elevated systolic pressure may increase mortality due to compromised perfusion.
More than 50% of the U.S. population 65 years and older have elevated systolic pressure with or without elevated diastolic pressure--and thus in either case are at risk for cerebrovascular and cardiovascular sequelae. As therapy lowers diastolic pressure, however, mortality can increase, presumably when blood pressure is brought down to levels that compromise perfusion.
Myron H. Weinberger (Fri,) studied this question.