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Isolated Systolic Hypertension

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1. Systolic-diastolic hypertension versus isolated systolic hypertension and incident heart failure in older adults: Insights from the Cardiovascular Health Study. (PubMed)

Systolic-diastolic hypertension versus isolated systolic hypertension and incident heart failure in older adults: Insights from the Cardiovascular Health Study. Isolated systolic hypertension (ISH) is common in older adults and is a risk factor for incident heart failure (HF). We examined the association of systolic-diastolic hypertension (SDH) with incident HF and other outcomes in older adults.In the Cardiovascular Health Study (CHS), 5776 community-dwelling adults≥65years had data (...) on baseline systolic and diastolic blood pressure (SBP and DBP). We excluded those with DBP<60mmHg (n=821), DBP≥90 and SBP<140mmHg (n=28), normal BP, taking anti-hypertensive drugs (n=1138), normal BP, not taking anti-hypertensive drugs, history of hypertension (n=193), and baseline HF (n=101). Of the remaining 3495, 1838 had ISH (SBP≥140 and DBP<90mmHg) and 240 had SDH (SBP≥140 and DBP≥90mmHg). The main outcome was centrally-adjudicated incident HF over 13years of follow-up.Participants had a mean (±SD

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2017 International journal of cardiology

2. Relation of Isolated Systolic Hypertension and Pulse Pressure to High-Sensitivity Cardiac Troponin-T and N-Terminal pro-B-Type Natriuretic Peptide in Older Adults (from the Atherosclerosis Risk in Communities Study). (PubMed)

Relation of Isolated Systolic Hypertension and Pulse Pressure to High-Sensitivity Cardiac Troponin-T and N-Terminal pro-B-Type Natriuretic Peptide in Older Adults (from the Atherosclerosis Risk in Communities Study). Isolated systolic hypertension (ISH) and elevated pulse pressure (PP) are common blood pressure (BP) abnormalities in older adults, reflect poor vascular compliance, and can signify risk for cardiovascular outcomes. We sought to characterize the associations of ISH and widened PP (...) with high-sensitivity Troponin-T (hs-cTnT; a marker of myocardial damage) and N-terminal pro-B-type natriuretic peptide (NT-proBNP; a marker of hemodynamic stress) levels in older adults. We performed a cross-sectional analysis of 5,251 Atherosclerosis Risk in Communities (ARIC) study participants without heart failure who attended visit 5 (2011 to 2013). We used logistic regression to evaluate the association of ISH (systolic BP ≥140 mm Hg and diastolic BP < 90 mm Hg) and quartiles of PP

2019 American Journal of Cardiology

3. Renal Denervation in Isolated Systolic Hypertension Using Different Catheter Techniques and Technologies. (PubMed)

Renal Denervation in Isolated Systolic Hypertension Using Different Catheter Techniques and Technologies. Patients with isolated systolic hypertension (ISH) are thought to show a diminished blood pressure (BP)-lowering effect after renal sympathetic denervation (RDN). This conclusion is mostly derived from unipolar radiofrequency catheter ablation studies. Limited data for newer RDN technologies exist. We used data from the RADIOSOUND-HTN (Three-Arm Randomized Trial of Different Renal (...) Denervation Devices and Techniques in Patients With Resistant Hypertension) comparing 3 different RDN approaches to investigate a possible interaction between ISH and RDN response. One hundred twenty patients were stratified by having ISH or combined systolic-diastolic hypertension (CH). Of these, 39 underwent radiofrequency ablation of the renal main arteries, 39 combined radiofrequency ablation of the main and branch arteries, and 42 were treated with ultrasound-based ablation of the main renal artery

2019 Hypertension Controlled trial quality: uncertain

4. Antihypertensive therapy prevents new-onset atrial fibrillation in patients with isolated systolic hypertension: the LIFE study. (PubMed)

Antihypertensive therapy prevents new-onset atrial fibrillation in patients with isolated systolic hypertension: the LIFE study. Aims: Atrial fibrillation (AF) is associated with increased cardiovascular risk and the incidence increases with age, hypertension and left ventricular hypertrophy (LVH). Reducing in-treatment systolic blood pressure (SBP) prevents new-onset AF but has previously not been studied in patients with isolated systolic hypertension (ISH). We aimed to investigate the effect (...) on preventing new-onset AF by decreased in-treatment SBP in patients with ISH compared to patients with non-ISH. Methods and results: Double-blind, randomized, parallel-group study of 1320 patients with ISH and electrocardiographic (ECG) LVH, included among the 9193 patients in the Losartan Intervention For Endpoint reduction in hypertension (LIFE) study. Annual ECGs were Minnesota coded centrally, and new-onset AF was evaluated in 1248 ISH patients and compared with 7583 non-ISH patients during mean 4.8

2019 Blood pressure Controlled trial quality: uncertain

5. The effects of slow loaded breathing training on exercise blood pressure in isolated systolic hypertension. (PubMed)

The effects of slow loaded breathing training on exercise blood pressure in isolated systolic hypertension. Slow loaded breathing training has been shown to reduce resting blood pressure (BP) in isolated systolic hypertension (ISH), but it is not known whether this also reduces their exaggerated BP responses to exercise.The study was a randomized controlled trial with block allocation stratified by sex. Twenty ISH patients (68 ± 5 yrs, 11 males) were randomized with one group undertaking 8 (...) -weeks training with slow loaded breathing (SLB: 25% maximum inspiratory pressure, 6 breaths per minute, 60 breaths every day) or deep breathing control (CON), with 8 weeks follow-up. Outcome measures were home BP and heart rate (HR) with laboratory measures of BP and HR responses to static handgrip and dynamic arm cranking exercise. Data were compared with a two-week run-in baseline.Home systolic BP fell by 22 mmHg (20-23; mean, 95% CI), diastolic BP by 9 mmHg (7-11), and HR by 12 bpm (9-15; all p

2019 Physiotherapy research international : the journal for researchers and clinicians in physical therapy Controlled trial quality: uncertain

6. Isolated systolic hypertension in the young: a position paper endorsed by the European Society of Hypertension. (PubMed)

Isolated systolic hypertension in the young: a position paper endorsed by the European Society of Hypertension. : Whether isolated systolic hypertension in the young (ISHY) implies a worse outcome and needs antihypertensive treatment is still a matter for dispute. ISHY is thought to have different mechanisms than systolic hypertension in the elderly. However, findings from previous studies have provided inconsistent results. From the analysis of the literature, two main lines of research (...) and conceptualization have emerged. Simultaneous assessment of peripheral and central blood pressure led to the identification of a condition called pseudo or spurious hypertension, which was considered an innocent condition. However, an increase in pulse wave velocity has been found by some authors in about 20% of the individuals with ISHY. In addition, obesity and metabolic disturbances have often been documented to be associated with ISHY both in children and young adults. The first aspect to consider whenever

2018 Journal of Hypertension

7. Effect of Arteriovenous Anastomosis on Blood Pressure Reduction in Patients With Isolated Systolic Hypertension Compared With Combined Hypertension. (PubMed)

Effect of Arteriovenous Anastomosis on Blood Pressure Reduction in Patients With Isolated Systolic Hypertension Compared With Combined Hypertension. Options for interventional therapy to lower blood pressure (BP) in patients with treatment-resistant hypertension include renal denervation and the creation of an arteriovenous anastomosis using the ROX coupler. It has been shown that BP response after renal denervation is greater in patients with combined hypertension (CH) than in patients (...) with isolated systolic hypertension (ISH). We analyzed the effect of ROX coupler implantation in patients with CH as compared with ISH.The randomized, controlled, prospective ROX Control Hypertension Study included patients with true treatment-resistant hypertension (office systolic BP ≥140 mm Hg, average daytime ambulatory BP ≥135/85 mm Hg, and treatment with ≥3 antihypertensive drugs including a diuretic). In a post hoc analysis, we stratified patients with CH (n=31) and ISH (n=11). Baseline office

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2017 Journal of the American Heart Association Controlled trial quality: uncertain

8. Isolated systolic hypertension of the young and its association with central blood pressure in a large multi-ethnic population. The HELIUS study (PubMed)

Isolated systolic hypertension of the young and its association with central blood pressure in a large multi-ethnic population. The HELIUS study Background Isolated systolic hypertension (ISH) of the young has been associated with both normal and increased cardiovascular risk, which has been attributed to differences in central systolic blood pressure and arterial stiffness. Methods We assessed the prevalence of ISH of the young and compared differences in central systolic blood pressure (...) and arterial stiffness between ISH and other hypertensive phenotypes in a multi-ethnic population of 3744 subjects (44% men), aged <40 years, participating in the HELIUS study. Results The overall prevalence of ISH was 2.7% (5.2% in men and 1.0% in women) with the highest prevalence in individuals of African descent. Subjects with ISH had lower central systolic blood pressure and pulse wave velocity compared with those with isolated diastolic or systolic-diastolic hypertension, resembling central systolic

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2018 European journal of preventive cardiology

9. The prognostic values of beta-2 microglobulin for risks of cardiovascular events and mortality in the elderly patients with isolated systolic hypertension (PubMed)

The prognostic values of beta-2 microglobulin for risks of cardiovascular events and mortality in the elderly patients with isolated systolic hypertension The present study aimed to investigate the effects of serum beta-2 microglobulin (B2M) on the risks of major cardiovascular events (MACEs) and all-cause death in Chinese elderly isolated systolic hypertension (ISH) patients without severe renal insufficiency (estimated glomerular filtration rate [eGFR] <30 ml/min/1.73 m2).Serum B2M

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2018 Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences

10. The effect of slow-loaded breathing training on the blood pressure response to handgrip exercise in patients with isolated systolic hypertension. (PubMed)

The effect of slow-loaded breathing training on the blood pressure response to handgrip exercise in patients with isolated systolic hypertension. Isolated systolic hypertension (ISH) is the most common form of hypertension in older people. It is characterized by increased resting systolic blood pressure (sBP) and increased sBP in response to exercise. It has previously been shown that slow breathing training reduces resting sBP, and the objective of the present study was to determine whether

2018 Hypertension research : official journal of the Japanese Society of Hypertension Controlled trial quality: uncertain

11. Effects of a low salt diet on isolated systolic hypertension: A community-based population study. (PubMed)

Effects of a low salt diet on isolated systolic hypertension: A community-based population study. Evidence has shown that long-term sodium reduction can not only reduce blood pressure, but also provide cardiovascular benefits. To date, there is little evidence related to the effects of salt reduction on isolated systolic hypertension (ISH).A total of 126 hypertensive patients were divided into an ISH group (n = 51) and a non-ISH (NISH) group (n = 75). The members of each group were (...) then randomly assigned to low sodium salt (LSSalt) or normal salt (NSalt) diets for 6 months. Their blood pressure was measured every 2 months. Serum plasma renin-angiotensin activity, blood biochemical assays and urinary measurements were determined at the baseline and at the end of the 6 months.At the end of the study, the mean systolic blood pressure (SBP) of the ISH LSSalt group had significantly decreased by 10.18 mm Hg (95% confidence interval (CI): 3.13 to 17.2, P = .006) compared

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2018 Medicine Controlled trial quality: uncertain

12. Slow loaded breathing training improves blood pressure, lung capacity and arm exercise endurance for older people with treated and stable isolated systolic hypertension. (PubMed)

Slow loaded breathing training improves blood pressure, lung capacity and arm exercise endurance for older people with treated and stable isolated systolic hypertension. Hypertension and reduced lung function are important features of aging. Slow loaded breathing training reduces resting blood pressure and the question is whether this can also improve lung function.Thirty-two people (67 ± 5 years, 16 male) with controlled isolated systolic hypertension undertook an eight weeks randomised (...) effective in reducing resting BP, even in older people with well controlled isolated systolic hypertension but also increases inspiratory muscle strength, lung capacity and arm exercise duration.Copyright © 2018. Published by Elsevier Inc.

2018 Experimental Gerontology Controlled trial quality: uncertain

13. Propofol Versus Thiopental for Rapid-Sequence Induction in Isolated Systolic Hypertensive Patients: A Factorial Randomized Double-Blind Clinical Trial (PubMed)

Propofol Versus Thiopental for Rapid-Sequence Induction in Isolated Systolic Hypertensive Patients: A Factorial Randomized Double-Blind Clinical Trial We investigated the effects of four different anaesthesia induction protocols on the haemodynamic response to laryngoscopy and tracheal intubation during rapid-sequence induction (RSI) in systolic hypertensive patients.One hundred and twenty hypertensive adult patients (systolic pressure >140 mmHg and diastolic pressure <90 mmHg), classified (...) in the remifentanil+thiopental group 1 minute after intubation (p<0.01); the mean arterial pressure values were 87±18 mmHg in the remifentanil+propofol group versus 105±25 mmHg in the remifentanil+thiopental group 1 minute after intubation (p<0.05).Propofol was not superior to thiopental for the attenuation of the response to laryngoscopy and intubation during RSI in systolic hypertensive patients, whereas propofol+remifentanil combination appears to be so in terms of the heart rate stability.

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2018 Turkish journal of anaesthesiology and reanimation Controlled trial quality: uncertain

14. Hemodynamic and Mechanical Properties of the Proximal Aorta in Young and Middle-Aged Adults With Isolated Systolic Hypertension: The Dallas Heart Study. (PubMed)

Hemodynamic and Mechanical Properties of the Proximal Aorta in Young and Middle-Aged Adults With Isolated Systolic Hypertension: The Dallas Heart Study. The aim of this study was to assess characteristic impedance (Zc) of the proximal aorta in young and middle-aged individuals with isolated systolic hypertension (ISH). Zc is an index of aortic stiffness relative to aortic size. In the Dallas Heart Study, 2001 untreated participants 18 to 64 years of age (mean age: 42.3 years; 44% black race (...) ) were divided into the following groups based on office blood pressure (BP) measurements: (1) optimal BP (systolic BP [SBP] <120 mm Hg and diastolic BP [DBP] <80 mm Hg; n=837); (2) prehypertension (SBP 120-139 mm Hg and DBP 80-89 mm Hg; n=821); (3) ISH (SBP ≥140 mm Hg and DBP <90 mm Hg; n=121); (4) isolated diastolic hypertension (SBP <140 mm Hg and DBP ≥90 mm Hg; n=44); and (5) systolic-diastolic hypertension (SBP ≥140 mm Hg and DBP ≥90 mm Hg; n=178). Zc, aortic arch pulse wave velocity

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2017 Hypertension

15. Pulse Wave Velocity Predicts Response to Renal Denervation in Isolated Systolic Hypertension (PubMed)

Pulse Wave Velocity Predicts Response to Renal Denervation in Isolated Systolic Hypertension Renal sympathetic denervation seems to be less effective as a treatment for hypertension in patients with isolated systolic hypertension, a condition associated with elevated central arterial stiffness. Because isolated systolic hypertension can also be caused by wave reflection or increased cardiac output, a more differentiated approach might improve patient preselection for renal sympathetic (...) hypertension) were included in our analysis. After 3 months, blood pressure reduction was more pronounced among patients with combined hypertension compared with patients with isolated systolic hypertension (systolic 24-hour average 9.3±10.5 versus 5.0±11.5 mm Hg, P=0.046). However, when stratifying patients with isolated systolic hypertension by invasive pulse wave velocity, patients in the lowest tertile of pulse wave velocity had comparable blood pressure reduction (12.1±12.6 mm Hg, P=0.006) despite

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2017 Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease

16. Reduced blood pressure-lowering effect of catheter-based renal denervation in patients with isolated systolic hypertension: data from SYMPLICITY HTN-3 and the Global SYMPLICITY Registry. (PubMed)

Reduced blood pressure-lowering effect of catheter-based renal denervation in patients with isolated systolic hypertension: data from SYMPLICITY HTN-3 and the Global SYMPLICITY Registry. Catheter-based renal artery denervation (RDN) has been shown to lower blood pressure (BP) in certain patients with uncontrolled hypertension. Isolated systolic hypertension (ISH) (systolic BP [SBP] ≥140 mmHg and diastolic BP <90 mmHg), characterized by increased vascular stiffness, is the predominant (...) hypertensive phenotype in elderly patients. This study compared baseline characteristics and SBP change at 6 months between patients with ISH and combined systolic–diastolic hypertension (CH).This study pooled data from 1103 patients from SYMPLICITY HTN-3 and the Global SYMPLICITY Registry. A total of 429 patients had ISH, and 674 had CH. Patients with ISH were significantly older than those with CH (66 vs. 55 years), had more type 2 diabetes mellitus (52.9 vs. 34.6%), and a lower estimated glomerular

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2017 European Heart Journal Controlled trial quality: uncertain

17. On-Treatment Blood Pressure and Cardiovascular Outcomes in Older Adults With Isolated Systolic Hypertension. (PubMed)

On-Treatment Blood Pressure and Cardiovascular Outcomes in Older Adults With Isolated Systolic Hypertension. Our aim was to assess optimal on-treatment blood pressure (BP) at which cardiovascular disease (CVD) and all-cause mortality risks are minimized in Japanese older adults with isolated systolic hypertension. We used data from the VALISH study (Valsartan in Elderly Isolated Systolic Hypertension) that recruited older adults (n=3035; mean age, 76 years) with systolic BP (SBP) of ≥160 mm Hg (...) risk. In conclusion, among Japanese older adults with isolated systolic hypertension, SBP in the range between 130 and 144 mm Hg was associated with minimal adverse outcomes and a reduction in CVD and all-cause mortality. The BP range will need to be confirmed in randomized controlled trials.URL: https://www.clinicaltrials.gov. Unique identifier: NCT00151229.© 2017 American Heart Association, Inc.

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2017 Hypertension Controlled trial quality: predicted high

18. Association of orthostatic hypertension with mortality in the Systolic Hypertension in the Elderly Program. (PubMed)

persons with isolated systolic hypertension (ISH). Men and women aged 60 years and above with ISH defined by a systolic blood pressure (SBP) of 160 mm Hg or higher and diastolic blood pressure lower than 90 mm Hg were randomized to chlorthalidone-based stepped care therapy or matching placebo. Among 4736 SHEP participants, 4073 had a normal orthostatic response, 203 had orthostatic hypertension, and 438 had orthostatic hypotension. Compared with normal response, orthostatic hypertension was associated (...) Association of orthostatic hypertension with mortality in the Systolic Hypertension in the Elderly Program. We examined the association of orthostatic hypertension with all-cause mortality in the active treatment and placebo randomized groups of the Systolic Hypertension in the Elderly Program (SHEP). SHEP was a multicenter, randomized, double-blind, placebo-controlled clinical trial of the effect of chlorthalidone-based antihypertensive treatment on the rate of occurrence of stroke among older

2019 Journal of human hypertension Controlled trial quality: predicted high

19. The legacy effect: 4.5 years of a chlorthalidone-based antihypertensive regimen reduces cardiovascular mortality and prolongs cardiovascular disease-free survival at 22 years for older patients with isolated systolic hypertension

The legacy effect: 4.5 years of a chlorthalidone-based antihypertensive regimen reduces cardiovascular mortality and prolongs cardiovascular disease-free survival at 22 years for older patients with isolated systolic hypertension The legacy effect: 4.5 years of a chlorthalidone-based antihypertensive regimen reduces cardiovascular mortality and prolongs cardiovascular disease-free survival at 22 years for older patients with isolated systolic hypertension | BMJ Evidence-Based Medicine We use (...) accounts Username * Password * your user name or password? You are here The legacy effect: 4.5 years of a chlorthalidone-based antihypertensive regimen reduces cardiovascular mortality and prolongs cardiovascular disease-free survival at 22 years for older patients with isolated systolic hypertension Article Text Therapeutics The legacy effect: 4.5 years of a chlorthalidone-based antihypertensive regimen reduces cardiovascular mortality and prolongs cardiovascular disease-free survival at 22 years

2012 Evidence-Based Medicine (Requires free registration)

20. Predictors of high central blood pressure in young with isolated systolic hypertension (PubMed)

Predictors of high central blood pressure in young with isolated systolic hypertension According to the European Society of Cardiology/European Society of Hypertension 2013 guidelines, evaluation of aortic blood pressure (BP) is needed in young with isolated systolic hypertension (ISH), but using special devices is not common, especially in Ukraine, where only a few centers have these devices. The purpose of our study was to identify the simple clinical predictors for differentiation (...) (with or without elevated aortic systolic BP [SBP]) of the young with ISH without the need for further extensive work-up.The study included 44 young men (mean age: 32.2±1.3 years) with office SBP ≥140 mmHg and office diastolic BP (DBP) <90 mmHg (average: 153.4±2.1 mmHg and 83.4±1.7 mmHg, respectively). The following procedures were performed in all the subjects: body weight and height evaluation; measurement of office SBP, DBP, and heart rate; ambulatory BP monitoring; measurement of pulse wave velocity

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2016 Vascular health and risk management

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