isolated
elevated systolic blood pressure is more
prevalent in older persons because of increased
large-artery stiffness.5 Recommendations from
the Seventh Report of the Joint
National Committee on Prevention,
Detection, Evaluation, and
Treatment of High Blood Pressure
(JNC 7) state that systolic
blood pressure should be the
primary target for the diagnosis
and care of older persons with hypertension.6-9
Blood pressure should be based on the average
of two or more properly measured readings, in
the sitting position, on two or more office visits.
6 Accurate measurement of blood pressure
in older persons can be challenging because of
cardiovascular changes associated with aging.
Age-related decreases in baroreflex response
may lead to orthostatic hypotension, so blood
pressure should be monitored in the sitting
and standing positions
calcium channel blockers are second-line medications that should
be selected based on comorbidities and risk factors. (Am Fam
Physician 2005;71:469-76. Copyright© 2005 American Academy
of Family Physicians.)