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Pressure DBP ; usually peaks in the fifth and sixth decades of life, but the systolic pressure continues to rise throughout the life of the individual due to progressive increases in vascular stiffness. As a result, isolated systolic hypertension ISH ; is dominant in the elderly. How does the aging process contribute to the development of ISH? There have been a variety of studies that have explained the pathophysiology of the ISH. Homma et al in 2001 demonstrated that the intima thickens due to cell proliferation and the formation of elastin, collagen and other components of connective tissue.1, 4 It has also been noted that medial calcification increases throughout aging.5 How common is ISH? The Canadian Heart Health Survey and Third National Health and Nutrition Examination Survey investigated the epidemiology of ISH.1, 3 , which was defined as SBP 140 mmHg and DBP 90 mmHg. Historically, elevated DBP has been felt to be the main determinant of hypertension-related CVD, and, as a consequence, older intervention trials have focused on lowering the DBP3 . ISH is a more powerful predicator of risk. Pulse pressure PP ; , which is the difference between peak SBP and DBP, is the most important blood pressure measurement in predicting cardiovascular risk, as confirmed by the Multiple Risk Factor Intervention Trial MRFIT ; in 1992 6 and later in many other studies. Numerous hypertension treatment trials in the elderly have been performed to assess the effects of treatment on reduction of cardiovascular risks. Examples include: Systolic Hypertension in the Elderly SHEP ; , Swedish Trial in Old Patients with Hypertension STOP-HTN ; , Medical Research Council trial of treatment of hypertension in older adults MRC ; , Systolic Hypertension in China SYS-China ; , Systolic Hypertension in Europe SYS-Eur ; , Hypertension Optimal Treatment HOT ; , Swedish Trial in old patients with Hypertension-2 STOP-2 ; , Intervention as a Goal in Hypertension Treatment INSIGHT ; , The Anti-hypertensive and Lipid Lowering Treatment to Prevent Heart Attack Trial ALLHAT ; , Second Australian National Blood Pressure Study ANBP2 ; , European Working Party on High Blood Pressure in the Elderly EWPHE ; . All of these studies included patients 50 yr. old with systolic hypertension. Several categories of drugs were tested with varying primary endpoints. Follow-up ranged from 2 to 5 years. Almost all showed significant risk reduction for CVD events with lowering of blood pressure. A modified table with the results is seen in Table 2. see p. 20 ; In the trials listed, a number of agents were tested including diuretics, beta-blockers, calcium channel blockers, alphablockers, centrally acting drugs, and angiotensin converting enzyme inhibitors, among others. Of the numerous drugs used, a pattern of benefit from diuretics, B-blockers, calcium channel blockers, and angiotension-converting enzyme inhibitors ACEI ; emerged. What is interesting and important is that simple medications not complex, newer, or expensive drugs ; were successful in several of these trials. In many of the studies, the SBP target of 140 mmHg was not reached, but, for instance, roche. PRENATAL FORMULA NATAFORT OBSTETRIX EC M-VIT DIALYVITE 3000 SUPERVITE VITALAN F.A. HYDROXOCOBALAMIN NEURO-K VITAMIN B-6 CALCIJEX ROCALTROL DHT DRISDOL. 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