The Systolic Hypertension in the Elderly Program

and 1971-74 [ 2] showed that the prevalence of hypertension, defined as a systolic blood pressure of greater than 160 mm Hg and a diastolic blood pressure equal to or above 95 mm Hg, is about 16% overall in the general adult population. The prevalence increases with age, is greater in the black population, and is found more commonly in women than in men. Hypertension has been shown unequivocally to be associated with increased cardiovascular morbidity and mortality [3,4]. The general form of essential is a relative increase in both systolic and diastolic pressures. With aging, systolic pressure rises out of proportion to any increase in the diastolic pressure [ 5-7] . The prevalence of combined systolic-diastolic stabilizes in late middle-age; as a result, a significant number of the elderly have an elevation in systolic pressure without a concomitant rise in diastolic pressure. Hence, the conditions known as predominantly systolic hypertension and isolated systolic hypertension (ISH) have been recognized. For the purpose of this study, ISH is defined as a systolic pressure of >160 mm Hg and a diastolic pressure < 90 mm Hg. ISH is thought to be mainly the end result of progressive arteriosclerotic changes in the media of the aorta and its large branches, with a loss of elastic fibers and an increase in the amount of cross