CLINICAL MANAGEMENT GUIDELINE

Systolic hypertension

ICD10: Essential (primary) hypertension [I10]

Treatment: Blood pressure control

ISH is defined as BP >140/<90 mmHg which is most commonly in >60 years old patients. It primarily associated with aortic wall weakening which is caused by aged elastin, collagen, and wall calcification.

Isolated systolic hypertension is characterized by a widened pulse pressure which is correlated to the adverse complications of ISH. In case of pulse pressure of > 40, evaluate of cardiovascular complications.


The primary goal of this plan gradually decreases the high systolic pressure with the priority to protect against stroke and cardiovascular adverse events.

The blood pressure goal is around 143/68 with the priority for the best adverse effect profile. Patients with diabetes or chronic renal disease 130/80 mm Hg or lower is advised.

Treatments

Level 1 / 2
pharmacological
Amlodipine
ROUTE
Oral
DOSE
5.000 mg
FREQUENCY
OD
prevention
Alcohol reduction program
prevention
Smoking cessation therapy
prevention
Weight reduction regimen
prevention
Low salt diet education
prevention
Aerobic exercises

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  • Duplicating mechanism of action of effect
  • Weight based dosing
  • Contraindication
  • Renal dosing
  • Interactions to drugs or diseases
  • Hepatic dosing

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