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Isolated systolic hypertension in the elderly poses a challenging problem. The merits of treating this condition have yet to be proven in a prospective trial, and the medical literature offers no consensus as to the best initial choice of therapy. Especially important in this age group is the need to avoid orthostatic hypotension from drug therapy. These investigators conducted a ten-week randomized, controlled trial of labetalol, a combined alpha and beta blocker, in 133 elderly patients with systolic blood pressure at or above 160 mm Hg and diastolic BP below 95 mm Hg.
Labetalol reduced systolic BP by a mean of 26 mm Hg, compared with 9 mm Hg in the placebo group, and controlled BP adequately in 81 percent of patients. Diastolic BP changed…