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Narrow the pulse pressure without non antihypertensive drug

For elderly hypertensive patients with increased pulse pressure, the traditional antihypertensive therapy is to narrow the pulse pressure through reducing the total peripheral vascular resistance, while the effect of such an approach is relatively limited. It is now believed that such factors as hypertension, hyperglycemia, dyslipidemia, and smoking can affect the function of blood vessels, thereby leading to increased pulse pressure. Therefore, improving arterial elasticity and function represents a new therapeutic approach to reducing the pulse pressure. In this regard, the administration of non-antihypertensive drugs can yield good effects. These drugs can be classified into the following categories:

Folic acid and vitamin B6
High homocysteine (HCY) can significantly injure the function of vascular endothelium and is closely associated with the genesis of atherosclerosis and elderly isolated systolic hypertension. Patients with a long-term administration of folic acid and vitamin B6 may have reduced plasma homocysteine, thereby improving arterial elasticity, while there is still a lack of positive experience in the dosage and duration of folic acid and vitamin B6 for changing arterial elasticity. 

Nitrate esters
This class of drugs can directly dilate the aortic vascular smooth muscles and improve the elasticity of the aorta, and they take effect faster. The commonly used drugs are nitroglycerin and isosorbide dinitrate, etc.

Statins
This class of drugs can not only regulate blood lipids and thus improve arterial elasticity, but also decrease the generation of oxygen free radicals. However, the effects of these drugs in improving arterial elasticity and narrowing pulse pressure are relatively slow and warrant long-term treatment. The commonly used statins are Pravastatin, Simvastatin, Fluvastatin, Lovastatin, etc.

Insulin sensitizers
Patients with insulin resistance should take this class of drugs while receiving the anti hypertensive therapy to improve the elasticity of blood vessels, while it takes 6 months for the drugs to take effect. The commonly used drugs are Melbine (DMBG), Troglitazone, Rosiglitazone, Pioglitazone, Phenformin, etc.

See also:
Blood pressure goals for elderly
The greater the pulse pressure is, the more risks there will be
Systolic hypertension in elderly (SBP > 160 mmHg, DBP < 90 mmHg)
Decreased systolic pressure can better indicate the actual effects of blood pressure control
Drugs for complications of hypertension in the elderly
Will Exceedingly Decreased Blood Pressure Lead to Stroke?

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