What is a common treatment for isolated systolic hypertension in the elderly?

• A. ACE inhibitors.
• B. Beta blockers.
• C. Calcium channel blockers (e.g., amlodipine, nifedipine).
• D. Thiazide diuretics.

Answer: (C)

Arterial stiffness from aging raises the systolic pressure while diastolic may stay the same or drop, so treatment focuses on lowering the afterload by dilating the arteries. Calcium channel blockers, especially the dihydropyridine type such as amlodipine or nifedipine, relax smooth muscle in the arterioles and reduce systemic vascular resistance. This directly lowers systolic blood pressure and reduces pulse pressure, which is exactly what isolated systolic hypertension in the elderly requires. They tend to have a reliable, targeted effect on the high systolic value without some of the heart-rate or metabolic concerns seen with other classes, making them a commonly chosen option in this scenario. Other medications can be used as well, but the standout fit for ISH in older adults is the calcium channel blocker approach.