Isolated systolic hypertension in the elderly

Systolic BP 140 mmHg or above with diastolic below 90. Predominant in patients over 60 due to decreased aortic elasticity. Thiazide-like diuretics and calcium channel blockers are first-line agents.

ICD-10 I101 drug

Also known as: ISH, Isolated systolic HTN

Drugs used for this condition

AIndapamideFirst line · Thiazide-like diureticsIn elderly patients with isolated systolic hypertension, thiazide-like diuretics are first-line. The HYVET trial showed a 30% stroke reduction and 21% all-cause mortality reduction with indapamide (with possible perindopril addition) in patients over 80. The PROGRESS trial confirmed reduced recurrent stroke risk with indapamide plus perindopril.

How to read tiers A–F

Evidence tiers belong to the drug-indication pair, not to the drug as a whole: the same substance can be A for one condition and F for another.

AStrong evidence – first or second line in international guidelines
BRecommended in selected cases
CStudy data contradict each other
DBenefit not proven, no documented harm
FDocumented harm, or risk without benefit