Hemodynamic mechanisms of and therapeutic approach to systolic hypertension.

Using noninvasive measurements of arterial diameter, compliance, and distensibility permits the mechanisms of increased systolic pressure in hypertensive humans to be better understood. Reduced arterial compliance causing a disproportionate increase in systolic pressure is a characteristic feature not only of pure systolic hypertension in the elderly but also of sustained essential systolodiastolic hypertension, mainly in persons aged over 50 years. Antihypertensive drugs should improve the status of large vessels through an active effect on the tone of the vascular smooth muscle of large arteries, a field as yet poorly investigated in hypertensive humans.