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Circulation, Vol 61, 1179-1182, Copyright © 1980 by American Heart Association
WB Kannel, TR Dawber and DL McGee
Diastolic hypertension has been widely and justifiably accepted as a cause
of cardiovascular mortality. However, it has also been accepted that the
cardiovascular sequelae of hypertension derive chiefly from the diastolic
component. Because systolic and diastolic pressure are usually highly
correlated it is not easy to dissociate the effects of each. Statistical
analysis suggests that systolic pressure is actually the more potent
contributor to cardiovascular sequelae. Even isolated systolic pressure
elevation is associated witn an excess cardiovascular mortality. At low
diastolic pressures (i.e., less than 95 mm Hg), risk rises with the level
of systolic pressure. Also, isolated systolic hypertension is most ominous
in the elderly, in whom it is highly prevalent. Isolated systolic
hypertension was related to the occurrence of "direct" complications as
well as to atherosclerotic sequelae. It was also associated with excess
mortality, taking into account rigid vessels as judged from pulse-wave
recordings. Trials to determine whether the treatment of isolated systolic
hypertension is efficacious for avoiding its demonstrated excess
cardiovascular morbidity and mortality are urgently needed.
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|
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|
|
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|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
 |
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
M. Hollenberg, D. T. Mangano, W. S. Browner, M. J. London, J. F. Tubau, I. M. Tateo, the Study of Perioperative Ischemia Research Group, D. T. Mangano, W. S. Browner, M. Hollenberg, et al. Predictors of Postoperative Myocardial Ischemia in Patients Undergoing Noncardiac Surgery JAMA, July 8, 1992; 268(2): 205 - 209. [Abstract] [PDF]
|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
R. A. Davidson and G. J. Caranasos Should the Elderly Hypertensive Be Treated? Evidence From Clinical Trials Arch Intern Med, November 1, 1987; 147(11): 1933 - 1937. [Abstract] [PDF]
|
|
|
|
|
|
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|
|
|
|
|
|
K. M. Hla, K. A. Vokaty, and J. R. Feussner Observer Error in Systolic Blood Pressure Measurement in the Elderly: A Case for Automatic Recorders? Arch Intern Med, December 1, 1986; 146(12): 2373 - 2376. [Abstract] [PDF]
|
|
|
|
|
|
J. J. Ferguson III and O. S. Randall Systolic, Diastolic, and Combined Hypertension: Differences Between Groups Arch Intern Med, June 1, 1986; 146(6): 1090 - 1093. [Abstract] [PDF]
|
|
|
|
 |
|
 R. A. Yeager, R. M. Weigel, E. S. Murphy, D. B. McConnell, T. M. Sasaki, and R. M. Vetto Application of Clinically Valid Cardiac Risk Factors to Aortic Aneurysm Surgery Arch Surg, March 1, 1986; 121(3): 278 - 281. [Abstract] [PDF]
|
|
|
|
|
|
S. Vaisrub Labile and Systolic Hypertension: A Reappraisal JAMA, March 27, 1981; 245(12): 1250 - 1250. [Abstract] [PDF]
|
|