Hypertension in the elderly: An evidence-based review

Current Pharmaceutical Design

Volumn 17, Issue 28, 2011, Pages 3020-3031

  Virdis, A ^a   Bruno, R M ^a   Neves, M Fritsch ^b   Bernini, G ^a   Taddei, S ^a   Ghiadoni, L ^a  

^a UNIVERSITY OF PISA   (Italy)

^b STATE UNIVERSITY OF RIO DE JANEIRO   (Brazil)

Author keywords

Elderly; Hypertension; Treatment

Indexed keywords

ARGININE; BETA ADRENERGIC RECEPTOR BLOCKING AGENT; CALCIUM ANTAGONIST; CHLORTALIDONE; DIPEPTIDYL CARBOXYPEPTIDASE INHIBITOR; INDAPAMIDE; LOSARTAN; NITRENDIPINE; NITRIC OXIDE; NORADRENALIN; PERINDOPRIL; PROSTAGLANDIN SYNTHASE; REACTIVE OXYGEN METABOLITE; REDUCED NICOTINAMIDE ADENINE DINUCLEOTIDE PHOSPHATE OXIDASE; TETRAHYDROBIOPTERIN; THIAZIDE DIURETIC AGENT; TRANDOLAPRIL;

AGED; AGING; ALCOHOL CONSUMPTION; ANTIHYPERTENSIVE THERAPY; ARTERIAL STIFFNESS; ARTERY COMPLIANCE; ARTERY DILATATION; ARTICLE; AUTONOMIC NERVOUS SYSTEM; BRACHIAL ARTERY; BRAIN HEMORRHAGE; BRAIN ISCHEMIA; CASE REPORT; CAUSE OF DEATH; CHRONIC KIDNEY DISEASE; COST OF ILLNESS; DEMENTIA; DIASTOLIC BLOOD PRESSURE; DIASTOLIC DYSFUNCTION; EVIDENCE BASED MEDICINE; GERIATRIC CARE; GERIATRIC DISORDER; GLOMERULUS FILTRATION RATE; HEART AFTERLOAD; HEART ATRIUM FIBRILLATION; HEART EJECTION FRACTION; HEART MUSCLE OXYGEN CONSUMPTION; HEART OUTPUT; HEART RATE; HIGH POTASSIUM INTAKE; HUMAN; HYPERTENSION; MEAN ARTERIAL PRESSURE; META ANALYSIS (TOPIC); MONOTHERAPY; ORTHOSTATIC HYPOTENSION; PATHOPHYSIOLOGY; PRESSORECEPTOR REFLEX; PREVALENCE; PRIORITY JOURNAL; PSEUDOHYPERTENSION; PULSE PRESSURE; PULSE WAVE; RANDOMIZED CONTROLLED TRIAL (TOPIC); RISK REDUCTION; SEX DIFFERENCE; SMOKING CESSATION; SODIUM RESTRICTION; STROKE; SYSTOLIC BLOOD PRESSURE; SYSTOLIC HYPERTENSION; VASCULAR RESISTANCE; VEIN INSUFFICIENCY; WEIGHT REDUCTION; WHITE COAT HYPERTENSION;

EID: 80054056434     PISSN: 13816128     EISSN: 18734286     Source Type: Journal    
DOI: 10.2174/138161211798157711     Document Type: Article

References (119)

1. World Population Prospects. The 2004 Revision., United Nations: New York 2005.
2. Taddei S, Virdis A, Ghiadoni L, Sudano I, Salvetti A. Antihypertensive drugs and reversing of endothelial dysfunction in hypertension. Curr Hypertens Rep 2000; 2: 64-70.
3. Roger VL, Go AS, Lloyd-Jones DM, et al. Heart disease and stroke statistics--2011 update: a report from the American Heart Association. Circulation 2011; 123: e18-e209.
4. Lloyd-Jones DM, Evans JC,Levy D. Hypertension in adults across the age spectrum: current outcomes and control in the community. JAMA 2005; 294: 466-472.
5. Lewington S, Clarke R, Qizilbash N, Peto R, Collins R. Agespecific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet 2002; 360: 1903-13.
6. Aronow WS, Fleg JL, Pepine CJ, et al. ACCF/AHA 2011 Expert Consensus Document on Hypertension in the Elderly A Report of the American College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents Developed in Collaboration With the American Academy of Neurology, American Geriatrics Society, American Society for Preventive Cardiology, American Society of Hypertension, American Society of Nephrology, Association of Black Cardiologists, and European Society of Hypertension. J Am Coll Cardiol 2011; 57: 2037-114.
7. Franklin SS, Jacobs MJ, Wong ND, L'Italien GJ,Lapuerta P. Predominance of isolated systolic hypertension among middle-aged and elderly US hypertensives: analysis based on National Health and Nutrition Examination Survey (NHANES) III. Hypertension 2001; 37: 869-74.
8. Franklin SS, Gustin Wt, Wong ND, et al. Hemodynamic patterns of age-related changes in blood pressure. The Framingham Heart Study. Circulation 1997; 96: 308-15.
9. Cifkova R, Pitha J, Lejskova M, Lanska V,Zecova S. Blood pressure around the menopause: a population study. J Hypertens 2008; 26: 1976-82.
10. Nichols WW, O'Rourke MF. McDonald's Blood Flow in Arteries: Theoretical, Experimental and Clinical Principles, Oxford University Press: New York 2005.
11. Safar ME, Levy BI,Struijker-Boudier H. Current perspectives on arterial stiffness and pulse pressure in hypertension and cardiovascular diseases. Circulation 2003; 107: 2864-9.
12. Ghiadoni L. Smoking and central blood pressure: a metabolic interaction? Am J Hypertens 2009; 22: 585.
13. Benjamin EJ, Larson MG, Keyes MJ, et al. Clinical correlates and heritability of flow-mediated dilation in the community: the Framingham Heart Study. Circulation 2004; 109: 613-9.
14. Mitchell GF. Effects of central arterial aging on the structure and function of the peripheral vasculature: implications for end-organ damage. J Appl Physiol 2008; 105: 1652-60.
15. Vyas M, Izzo JL, Jr., Lacourciere Y, et al. Augmentation index and central aortic stiffness in middle-aged to elderly individuals. Am J Hypertens 2007; 20: 642-7.
16. Sutton-Tyrrell K, Najjar SS, Boudreau RM, et al. Elevated aortic pulse wave velocity, a marker of arterial stiffness, predicts cardiovascular events in well-functioning older adults. Circulation 2005; 111: 3384-90.
17. Cecelja M, Chowienczyk P. Dissociation of aortic pulse wave velocity with risk factors for cardiovascular disease other than hypertension: a systematic review. Hypertension 2009; 54: 1328-36.
18. Laurent S. Arterial wall hypertrophy and stiffness in essential hypertensive patients. Hypertension 1995; 26: 355-62.
19. Blacher J, Staessen JA, Girerd X, et al. Pulse pressure not mean pressure determines cardiovascular risk in older hypertensive patients. Arch Intern Med 2000; 160: 1085-9.
20. Alderman MH, Cohen H, Madhavan S. Distribution and determinants of cardiovascular events during 20 years of successful antihypertensive treatment. J Hypertens 1998; 16: 761-9.
21. Virdis A, Ghiadoni L, Giannarelli C, Taddei S. Endothelial dysfunction and vascular disease in later life. Maturitas 2010; 67: 20-4.
22. Taddei S, Virdis A, Ghiadoni L, et al. Age-related reduction of NO availability and oxidative stress in humans. Hypertension 2001; 38: 274-9.
23. Celermajer DS, Dollery C, Burch M, Deanfield JE. Role of endothelium in the maintenance of low pulmonary vascular tone in normal children. Circulation 1994; 89: 2041-4.
24. Taddei S, Virdis A, Ghiadoni L, Magagna A, Salvetti A. Vitamin C improves endothelium-dependent vasodilation by restoring nitric oxide activity in essential hypertension. Circulation 1998; 97: 2222-9.
25. Donato AJ, Eskurza I, Silver AE, et al. Direct evidence of endothelial oxidative stress with aging in humans: relation to impaired endothelium- dependent dilation and upregulation of nuclear factorkappaB. Circ Res 2007; 100: 1659-66.
26. Eskurza I, Myerburgh LA, Kahn ZD, Seals DR. Tetrahydrobiopterin augments endothelium-dependent dilatation in sedentary but not in habitually exercising older adults. J Physiol 2005; 568: 1057-65.
27. Van Guilder GP, Westby CM, Greiner JJ, Stauffer BL, DeSouza CA. Endothelin-1 vasoconstrictor tone increases with age in healthy men but can be reduced by regular aerobic exercise. Hypertension 2007; 50: 403-9.
28. Rundek T, Hundle R, Ratchford E, et al. Endothelial dysfunction is associated with carotid plaque: a cross-sectional study from the population based Northern Manhattan Study. BMC Cardiovasc Disord 2006; 6: 35.
29. McEniery CM, Qasem A, Schmitt M, Avolio AP, Cockcroft JR, Wilkinson IB. Endothelin-1 regulates arterial pulse wave velocity in vivo. J Am Coll Cardiol 2003; 42: 1975-81.
30. McEniery CM, Wallace S, Mackenzie IS, et al. Endothelial function is associated with pulse pressure, pulse wave velocity, and augmentation index in healthy humans. Hypertension 2006; 48: 602-8.
31. Wallace SM, Yasmin, McEniery CM, et al. Isolated systolic hypertension is characterized by increased aortic stiffness and endothelial dysfunction. Hypertension 2007; 50: 228-33.
32. Lakatta EG. Arterial and cardiac aging: major shareholders in cardiovascular disease enterprises: Part III: cellular and molecular clues to heart and arterial aging. Circulation 2003; 107: 490-7.
33. Gerstenblith G, Frederiksen J, Yin FC, Fortuin NJ, Lakatta EG, Weisfeldt ML. Echocardiographic assessment of a normal adult aging population. Circulation 1977; 56: 273-8.
34. Benjamin EJ, Levy D, Anderson KM, et al. Determinants of Doppler indexes of left ventricular diastolic function in normal subjects (the Framingham Heart Study). Am J Cardiol 1992; 70: 508-15.
35. Aurigemma GP, Gottdiener JS, Shemanski L, Gardin J,Kitzman D. Predictive value of systolic and diastolic function for incident congestive heart failure in the elderly: the cardiovascular health study. J Am Coll Cardiol 2001; 37: 1042-8.
36. Feinberg WM, Blackshear JL, Laupacis A, Kronmal R, Hart RG. Prevalence, age distribution, and gender of patients with atrial fibrillation. Analysis and implications. Arch Intern Med 1995; 155: 469-73.
37. Leung MC, Meredith IT, Cameron JD. Aortic stiffness affects the coronary blood flow response to percutaneous coronary intervention. Am J Physiol Heart Circ Physiol 2006; 290: H624-30.
38. Pepine CJ, Nichols WW. The pathophysiology of chronic ischemic heart disease. Clin Cardiol 2007; 30: I4-9.
39. Zanchetti A, Cuspidi C, Comarella L, et al. Left ventricular diastolic dysfunction in elderly hypertensives: results of the APROSdiadys study. J Hypertens 2007; 25: 2158-67.
40. Kaye DM, Esler MD. Autonomic control of the aging heart. Neuromolecular Med 2008; 10: 179-86.
41. Leenen FH, Coletta E, Fourney A, White R. Aging and cardiac responses to epinephrine in humans: role of neuronal uptake. Am J Physiol Heart Circ Physiol 2005; 288: H2498-503.
42. Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin E after myocardial infarction: results of the GISSIPrevenzione trial. Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto miocardico. Lancet 1999; 354: 447-55.
43. Grassi G, Seravalle G, Bertinieri G, et al. Sympathetic and reflex alterations in systo-diastolic and systolic hypertension of the elderly. J Hypertens 2000; 18: 587-93.
44. Cleroux J, Giannattasio C, Bolla G, et al. Decreased cardiopulmonary reflexes with aging in normotensive humans. Am J Physiol 1989; 257: H961-8.
45. Monahan KD. Effect of aging on baroreflex function in humans. Am J Physiol Regul Integr Comp Physiol 2007; 293: R3-12.
46. Monahan KD, Dinenno FA, Seals DR, Clevenger CM, Desouza CA, Tanaka H. Age-associated changes in cardiovagal baroreflex sensitivity are related to central arterial compliance. Am J Physiol Heart Circ Physiol 2001; 281: H284-9.
47. Hunt BE, Farquhar WB, Taylor JA. Does reduced vascular stiffening fully explain preserved cardiovagal baroreflex function in older, physically active men? Circulation 2001; 103: 2424-7.
48. Masaki KH, Schatz IJ, Burchfiel CM, et al. Orthostatic hypotension predicts mortality in elderly men: the Honolulu Heart Program. Circulation 1998; 98: 2290-5.
49. Matsukawa T, Sugiyama Y, Watanabe T, Kobayashi F, Mano T. Gender difference in age-related changes in muscle sympathetic nerve activity in healthy subjects. Am J Physiol 1998; 275: R1600-4.
50. Fu Q, Vongpatanasin W, Levine BD. Neural and nonneural mechanisms for sex differences in elderly hypertension: can exercise training help? Hypertension 2008; 52: 787-94.
51. Verhave JC, Fesler P, du Cailar G, Ribstein J, Safar ME, Mimran A. Elevated pulse pressure is associated with low renal function in elderly patients with isolated systolic hypertension. Hypertension 2005; 45: 586-91.
52. Schillaci G, Pirro M, Mannarino MR, et al. Relation between renal function within the normal range and central and peripheral arterial stiffness in hypertension. Hypertension 2006; 48: 616-21.
53. Ford ML, Tomlinson LA, Chapman TP, Rajkumar C, Holt SG. Aortic stiffness is independently associated with rate of renal function decline in chronic kidney disease stages 3 and 4. Hypertension 2010; 55: 1110-5.
54. Persell SD. Prevalence of resistant hypertension in the United States, 2003-2008. Hypertension 2011; 57: 1076-80.
55. Zemel MB, Sowers JR. Salt sensitivity and systemic hypertension in the elderly. Am J Cardiol 1988; 61: 7H-12H.
56. Prevention of stroke by antihypertensive drug treatment in older persons with isolated systolic hypertension. Final results of the Systolic Hypertension in the Elderly Program (SHEP). SHEP Cooperative Research Group. Jama 1991; 265: 3255-64.
57. Staessen JA, Fagard R, Thijs L, et al. Randomised double-blind comparison of placebo and active treatment for older patients with isolated systolic hypertension. The Systolic Hypertension in Europe (Syst-Eur) Trial Investigators. Lancet 1997; 350: 757-64.
58. Randomised trial of a perindopril-based blood-pressure-lowering regimen among 6,105 individuals with previous stroke or transient ischaemic attack. Lancet 2001; 358: 1033-41.
59. Beckett NS, Peters R, Fletcher AE, et al. Treatment of hypertension in patients 80 years of age or older. N Engl J Med 2008; 358: 1887-98. Epub 2008 Mar 1831.
60. Mancia G, De Backer G, Dominiczak A, et al. Guidelines for the Management of Arterial Hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens 2007; 25: 1105-87.
61. Kilander L, Nyman H, Boberg M, Hansson L,Lithell H. Hypertension is related to cognitive impairment: a 20-year follow-up of 999 men. Hypertension 1998; 31: 780-6.
62. Launer LJ, Masaki K, Petrovitch H, Foley D, Havlik RJ. The association between midlife blood pressure levels and late-life cognitive function. The Honolulu-Asia Aging Study. Jama 1995; 274: 1846-51.
63. Sierra C, de La Sierra A, Mercader J, Gomez-Angelats E, Urbano- Marquez A,Coca A. Silent cerebral white matter lesions in middleaged essential hypertensive patients. J Hypertens 2002; 20: 519-24.
64. Vermeer SE, Prins ND, den Heijer T, Hofman A, Koudstaal PJ,Breteler MM. Silent brain infarcts and the risk of dementia and cognitive decline. N Engl J Med 2003; 348: 1215-22.
65. Birns J, Morris R, Donaldson N,Kalra L. The effects of blood pressure reduction on cognitive function: a review of effects based on pooled data from clinical trials. J Hypertens 2006; 24: 1907-14.
66. Peters R, Beckett N, Forette F, et al. Incident dementia and blood pressure lowering in the Hypertension in the Very Elderly Trial cognitive function assessment (HYVET-COG): a double-blind, placebo controlled trial. Lancet Neurol 2008; 7: 683-9. Epub 2008 Jul 2007.
67. Turnbull F, Neal B, Ninomiya T, et al. Effects of different regimens to lower blood pressure on major cardiovascular events in older and younger adults: meta-analysis of randomised trials. Bmj 2008; 336: 1121-3. Epub 2008 May 1114.
68. Messerli FH, Mancia G, Conti CR, et al. Dogma disputed: can aggressively lowering blood pressure in hypertensive patients with coronary artery disease be dangerous? Ann Intern Med 2006; 144: 884-93.
69. Sleight P, Redon J, Verdecchia P, et al. Prognostic value of blood pressure in patients with high vascular risk in the Ongoing Telmisartan Alone and in combination with Ramipril Global Endpoint Trial study. J Hypertens 2009; 27: 1360-9.
70. Denardo SJ, Gong Y, Nichols WW, et al. Blood pressure and outcomes in very old hypertensive coronary artery disease patients: an INVEST substudy. Am; 123: 719-26.
71. Lakatta EG. Age-associated cardiovascular changes in health: impact on cardiovascular disease in older persons. Heart Fail Rev 2002; 7: 29-49.
72. Davis BR, Kostis JB, Simpson LM, et al. Heart failure with preserved and reduced left ventricular ejection fraction in the antihypertensive and lipid-lowering treatment to prevent heart attack trial. Circulation 2008; 118: 2259-67.
73. de Simone G, Gottdiener JS, Chinali M, Maurer MS. Left ventricular mass predicts heart failure not related to previous myocardial infarction: the Cardiovascular Health Study. Eur Heart J 2008; 29: 741-7.
74. Aronow WS, Ahn C, Kronzon I, Koenigsberg M. Congestive heart failure, coronary events and atherothrombotic brain infarction in elderly blacks and whites with systemic hypertension and with and without echocardiographic and electrocardiographic evidence of left ventricular hypertrophy. Am J Cardiol 1991; 67: 295-9.
75. Levy D, Garrison RJ, Savage DD, Kannel WB, Castelli WP. Left ventricular mass and incidence of coronary heart disease in an elderly cohort. The Framingham Heart Study. Ann Intern Med 1989; 110: 101-7.
76. Mathew J, Sleight P, Lonn E, et al. Reduction of cardiovascular risk by regression of electrocardiographic markers of left ventricular hypertrophy by the angiotensin-converting enzyme inhibitor ramipril. Circulation 2001; 104: 1615-21.
77. Okin PM, Devereux RB, Harris KE, et al. Regression of electrocardiographic left ventricular hypertrophy is associated with less hospitalization for heart failure in hypertensive patients. Ann Intern Med 2007; 147: 311-9.
78. Solomon SD, Janardhanan R, Verma A, et al. Effect of angiotensin receptor blockade and antihypertensive drugs on diastolic function in patients with hypertension and diastolic dysfunction: a randomised trial. Lancet 2007; 369: 2079-87.
79. Wachtell K, Okin PM, Olsen MH, et al. Regression of electrocardiographic left ventricular hypertrophy during antihypertensive therapy and reduction in sudden cardiac death: the LIFE Study. Circulation 2007; 116: 700-5.
80. Baggio B, Budakovic A, Perissinotto E, et al. Atherosclerotic risk factors and renal function in the elderly: the role of hyperfibrinogenaemia and smoking. Results from the Italian Longitudinal Study on Ageing (ILSA). Nephrol Dial Transplant 2005; 20: 114-23.
81. Chae CU, Albert CM, Glynn RJ, Guralnik JM, Curhan GC. Mild renal insufficiency and risk of congestive heart failure in men and women > or =70 years of age. Am J Cardiol 2003; 92: 682-6.
82. Fried LF, Shlipak MG, Crump C, et al. Renal insufficiency as a predictor of cardiovascular outcomes and mortality in elderly individuals. J Am Coll Cardiol 2003; 41: 1364-72.
83. Hemmelgarn BR, Zhang J, Manns BJ, et al. Progression of kidney dysfunction in the community-dwelling elderly. Kidney Int 2006; 69: 2155-61.
84. Zanchetti A. Bottom blood pressure or bottom cardiovascular risk? How far can cardiovascular risk be reduced? J Hypertens 2009; 27: 1509-20.
85. Ibsen H. Antihypertensive treatment and risk of cardiovascular complications: is the cure worse than the disease? J Hypertens 2009; 27: 221-3.
86. Sega R, Cesana G, Bombelli M, et al. Seasonal variations in home and ambulatory blood pressure in the PAMELA population. Pressione Arteriose Monitorate E Loro Associazioni. J Hypertens 1998; 16: 1585-92.
87. Modesti PA, Morabito M, Bertolozzi I, et al. Weather-related changes in 24-hour blood pressure profile: effects of age and implications for hypertension management. Hypertension 2006; 47: 155-61.
88. O'Brien E, Asmar R, Beilin L, et al. European Society of Hypertension recommendations for conventional, ambulatory and home blood pressure measurement. J Hypertens 2003; 21: 821-48.
89. Aronow WS, Ahn C. Postprandial hypotension in 499 elderly persons in a long-term health care facility. J Am Geriatr Soc 1994; 42: 930-2.
90. Cavallini MC, Roman MJ, Blank SG, Pini R, Pickering TG, Devereux RB. Association of the auscultatory gap with vascular disease in hypertensive patients. Ann Intern Med 1996; 124: 877-83.
91. Wright JC, Looney SW. Prevalence of positive Osler's manoeuver in 3387 persons screened for the Systolic Hypertension in the Elderly Program (SHEP). J Hum Hypertens 1997; 11: 285-9.
92. Jaffe R, Halon DA, Weisz G, Lewis BS. Pseudohypertension [correction of Pseudohypotension] in a patient with malignant hypertension. Isr Med Assoc J 2000; 2: 484-5.
93. Spence JD. Pseudo-hypertension in the elderly: still hazy, after all these years. J Hum Hypertens 1997; 11: 621-3.
94. Sleight P. Smoking and hypertension. Clin Exp Hypertens 1993; 15: 1181-92.
95. Virdis A, Giannarelli C, Neves MF, Taddei S, Ghiadoni L. Cigarette smoking and hypertension. Curr Pharm Des; 16: 2518-25.
96. Halimi JM, Giraudeau B, Vol S, Caces E, Nivet H, Tichet J. The risk of hypertension in men: direct and indirect effects of chronic smoking. J Hypertens 2002; 20: 187-93.
97. Hall SM, Humfleet GL, Gorecki JA, Munoz RF, Reus VI, Prochaska JJ. Older versus younger treatment-seeking smokers: differences in smoking behavior, drug and alcohol use, and psychosocial and physical functioning. Nicotine Tob Res 2008; 10: 463-70.
98. Donze J, Ruffieux C, Cornuz J. Determinants of smoking and cessation in older women. Age Ageing 2007; 36: 53-7.
99. Appel DW, Aldrich TK. Smoking cessation in the elderly. Clin Geriatr Med 2003; 19: 77-100.
100. Houston TK, Allison JJ, Person S, Kovac S, Williams OD, Kiefe CI. Post-myocardial infarction smoking cessation counseling: associations with immediate and late mortality in older Medicare patients. Am J Med 2005; 118: 269-275.
101. Whelton PK, Appel LJ, Espeland MA, et al. Sodium reduction and weight loss in the treatment of hypertension in older persons: a randomized controlled trial of nonpharmacologic interventions in the elderly (TONE). TONE Collaborative Research Group. Jama 1998; 279: 839-46.
102. Midgley JP, Matthew AG, Greenwood CM, Logan AG. Effect of reduced dietary sodium on blood pressure: a meta-analysis of randomized controlled trials. Jama 1996; 275: 1590-7.
103. Whelton PK, He J, Cutler JA, et al. Effects of oral potassium on blood pressure. Meta-analysis of randomized controlled clinical trials. Jama 1997; 277: 1624-32.
104. Svetkey LP, Simons-Morton D, Vollmer WM, et al. Effects of dietary patterns on blood pressure: subgroup analysis of the Dietary Approaches to Stop Hypertension (DASH) randomized clinical trial. Arch Intern Med 1999; 159: 285-93.
105. Cushman WC, Cutler JA, Hanna E, et al. Prevention and Treatment of Hypertension Study (PATHS): effects of an alcohol treatment program on blood pressure. Arch Intern Med 1998; 158: 1197-207.
106. Wannamethee SG, Shaper AG. Patterns of alcohol intake and risk of stroke in middle-aged British men. Stroke 1996; 27: 1033-9.
107. Whelton SP, Chin A, Xin X, He J. Effect of aerobic exercise on blood pressure: a meta-analysis of randomized, controlled trials. Ann Intern Med 2002; 136: 493-503.
108. Hagberg JM, Montain SJ, Martin WH, 3rd, Ehsani AA. Effect of exercise training in 60- to 69-year-old persons with essential hypertension. Am J Cardiol 1989; 64: 348-53.
109. Cononie CC, Graves JE, Pollock ML, Phillips MI, Sumners C, Hagberg JM. Effect of exercise training on blood pressure in 70- to 79-yr-old men and women. Med Sci Sports Exerc 1991; 23: 505-11.
110. Thijs L, Fagard R, Lijnen P, Staessen J, Van Hoof R, Amery A. A meta-analysis of outcome trials in elderly hypertensives. J Hypertens 1992; 10: 1103-9.
111. Staessen JA, Gasowski J, Wang JG, et al. Risks of untreated and treated isolated systolic hypertension in the elderly: meta-analysis of outcome trials. Lancet 2000; 355: 865-72.
112. Gueyffier F, Bulpitt C, Boissel JP, et al. Antihypertensive drugs in very old people: a subgroup meta-analysis of randomised controlled trials. INDANA Group. Lancet 1999; 353: 793-6.
113. Wang JG, Staessen JA, Franklin SS, Fagard R, Gueyffier F. Systolic and diastolic blood pressure lowering as determinants of cardiovascular outcome. Hypertension 2005; 45: 907-13.
114. Mancia G, Laurent S, Agabiti-Rosei E, et al. Reappraisal of European guidelines on hypertension management: a European Society of Hypertension Task Force document. J Hypertens 2009; 27: 2121-58.
115. Principal results of the Japanese trial to assess optimal systolic blood pressure in elderly hypertensive patients (JATOS). Hypertens Res 2008; 31: 2115-27.
116. Yusuf S, Diener HC, Sacco RL, et al. Telmisartan to prevent recurrent stroke and cardiovascular events. N Engl J Med 2008; 359: 1225-37.
117. Yusuf S, Teo K, Anderson C, et al. Effects of the angiotensinreceptor blocker telmisartan on cardiovascular events in high-risk patients intolerant to angiotensin-converting enzyme inhibitors: a randomised controlled trial. Lancet 2008; 372: 1174-83.
118. Bangalore S, Messerli FH, Wun CC, et al. J-curve revisited: An analysis of blood pressure and cardiovascular events in the Treating to New Targets (TNT) Trial. Eur; 31: 2897-908.
119. Boshuizen HC, Izaks GJ, van Buuren S, Ligthart GJ. Blood pressure and mortality in elderly people aged 85 and older: community based study. Bmj 1998; 316: 1780-4.