Stroke is a major cause of morbidity and mortality in older men and women, and advanced age is the most consistent risk factor for all types of stroke.1 Recent controlled studies evaluating the treatment of two major risk factors for stroke, isolated systolic hypertension (ISH) and nonvalvular atrial fibrillation, have shown considerable benefit in reducing stroke rate, even in the oldest age groups.
Defined as systolic blood pressure greater than 160 mm Hg and diastolic blood pressure less than 90 mm Hg, ISH increases with age secondary to a decrease in arterial compliance.2 The risks of cardiovascular and cerebrovascular events are increased with ISH; for any given systolic blood pressure, the oldest age groups have the highest number of events.3,4
The Systolic Hypertension in the Elderly Program was initiated to examine the effectiveness of ISH treatment in persons older than 60 years.5 Just less than 5000
Prestwood KM, Besdine RW. Geriatric Medicine. JAMA. 1992;268(3):360-362. doi:10.1001/jama.1992.03490030072033