-Hypertension in those under ages 50-60 is both a systolic and diastolic disease. However, with age, diastolic pressures fall and hypertension becomes exclusively a systolic phenomenon. As such, you shouldn't content yourself with a "controlled" diastolic pressure as low-normal pressures are the norm.
-Given that the rate of rise of systolic pressure is more rapid in hypertensives, it is expected that they will require additional agents with aging, even if their other risk factors are unchanged.
-With falling diastolic pressures, management challenges include lowering systolic pressures while avoiding excessively low diastolic pressures (to be discussed in coming issues).