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November 24, 2004

Systolic Hypertension in Elderly Persons—Reply

JAMA. 2004;292(20):2465-2466. doi:10.1001/jama.292.20.2466-a

In Reply: Dr Baker suggests that there is sufficient evidence embedded in current trials to conclude that moderate elevation of SBP should be treated, but his inferences require a fair amount of speculation and are far from definitive. The treatment of moderate elevation in SBP may, on average, reduce the risk of cardiovascular disease and stroke in older patients. However, until a clinical trial directly addresses the benefit of treating this specific group, we believe that uncertainty about that benefit emphasizes the importance of shared decision making in these patients, which includes a discussion of the strength of the current clinical evidence.

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