What is the focus of the literature on management of elderly patients?
The literature on management of elderly patients has been focused more on systolic than diastolic BP. There is relevant observational evidence from the SHEP study.374 In an analysis of 2181 persons 465 years of age in the placebo arm of this study, systolic BP was more predictive of decline in kidney function (i.e., rise in SCr by Z0.4 mg/dl [35.4 mmol/l] over 5 years) than diastolic BP, pulse pressure, or MAP.