Treatment of hypertension based on both systolic and diastolic pressure could influence the cost of therapy.

The decision to start antihypertensive treatment is based on the statistical results of therapeutic trials done in large populations. The application of statistical estimations may extend the indications for antihypertensive therapy to individual subjects who might be marginally improved by antihypertensive treatment. This problem is due to the well-known heterogeneity of the hypertensive population. One of the most common factors reflecting the heterogeneity of this population is the level of systolic pressure versus that of diastolic pressure. Disproportionate increases in systolic pressure in patients over 50 years reflect principally the arterial changes associated with elevated blood pressure. Arterial changes, as evidenced by the decreased compliance of large arteries, may require a specific therapeutic approach, which could influence the choice and consequently the cost of antihypertensive therapy.