News - Hypertension Week of March 2, 2003/ Vol. 2 No. 09

Study: Better Systolic Hypertension Control Needed

More effective medications are needed to control isolated systolic hypertension, the cause of high blood pressure in many older people, according to a study reported in the February issue of the American Journal of Hypertension.

Isolated systolic hypertension is a condition where systolic blood pressure is high but diastolic blood pressure is normal.

University of Arkansas researchers studied 585 patients, including 245 with uncontrolled hypertension. In the uncontrolled group, 189 patients had uncontrolled isolated systolic hypertension and 56 had uncontrolled diastolic hypertension.

Despite having uncontrolled systolic hypertension, patients in this category still received more antihypertensive medications than those with controlled hypertension.

"This indicates that physicians were attempting to control blood pressure by prescribing additional medications," the researchers noted.

Of the patients with uncontrolled systolic hypertension, researchers said 43.1 percent of the patients were on diuretics; 41.9 percent on ACE inhibitors, 35 percent on beta-blockers and 32.9 percent on calcium channel blockers. The researchers added that none of these blood pressure medications were significantly associated with better systolic blood pressure control.

"There is a need to develop new medications that will control isolated systolic hypertension," concluded the researchers. "We believe that the major reason for poor control of isolated systolic hypertension is the unavailability of medications that can effectively control it without decreasing the diastolic blood pressure."

Ideally, the researchers said any new medications should effectively lower systolic blood pressure without affecting diastolic blood pressure.

Michael A. Weber, an editor of the journal, said the study affirms the importance of controlling systolic hypertension. "Physicians must pay increased attention to systolic blood pressure since it increases as people age and becomes a major risk factor for heart attacks and strokes," he said.

As the US population grows older, Weber said physicians would see more patients with isolated systolic blood pressure, a condition that is more difficult to control. "Although there is growing evidence regarding the benefits of controlling of isolated systolic hypertension, it remains a difficult treatment problem and as the investigators point out, it may be attributed to a lack of effective medications," he said.

Other sources: American Journal of Hypertension: February 2003; 16:140-143