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Arch Intern Med. 2001;161:1480-1482.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

UNCERTAINTY exists as to the appropriate goal of antihypertensive therapy that will provide maximal protection for the majority of patients. In particular, recently published data show an increase in cardiovascular events in elderly patients with isolated systolic hypertension whose diastolic levels were inadvertently lowered to below 65 mm Hg by therapy. Whether such a J-curve exists for those with combined systolic and diastolic hypertension is less certain.

Whereas the goal of 140/90 mm Hg seems appropriate for relatively low-risk hypertensive patients, more intensive therapy to reach a goal below 130/80 mm Hg is indicated for those with high-risk hypertension, including those with diabetes or renal insufficiency. Caution is needed if diastolic levels go below 65 mm Hg in those with isolated systolic hypertension.

BACKGROUND

With increasing age, systolic blood pressure (BP) continues to rise, whereas diastolic BP reaches its peak in the fifth decade of life and then decreases, a reflection . . . [Full Text of this Article]

DIASTOLIC HYPERTENSION: STUDIES SUPPORTING A J-CURVE

DIASTOLIC HYPERTENSION: STUDIES REFUTING A J-CURVE

HYPERTENSION OPTIMAL TREATMENT TRIAL

ISOLATED SYSTOLIC HYPERTENSION

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