What is the preferred treatment for isolated systolic hypertension in the elderly?

In the treatment of isolated systolic hypertension in the elderly, thiazide diuretics and long-acting dihydropyridine calcium channel blockers are preferred due to their effectiveness in lowering blood pressure and their favorable side effect profile in this population. Isolated systolic hypertension, characterized by elevated systolic blood pressure with normal diastolic pressure, is particularly common in older adults and can lead to increased cardiovascular risk if not properly managed.

Thiazide diuretics work by reducing blood volume and, consequently, decreasing cardiac output, which helps to lower systolic blood pressure. They are effective in this demographic and are often well-tolerated. Long-acting dihydropyridine calcium channel blockers are also effective because they cause vasodilation, leading to a decrease in peripheral vascular resistance. Their extended duration of action is beneficial for maintaining stable blood pressure control throughout the day.

While other classes, such as ACE inhibitors and ARBs, can be used, their primary benefits are more pronounced in patients with specific comorbid conditions like heart failure or chronic kidney disease rather than isolated systolic hypertension. Beta-blockers, although effective in some scenarios, are generally not recommended as first-line therapy for isolated systolic hypertension in the elderly unless there are