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Systolic High Blood Pressure

What Is Systolic High Blood Pressure?

Blood pressure is typically recorded as two numbers — the systolic pressure (as the heart beats) over the diastolic pressure (as the heart relaxes between beats). Optimal blood pressure is less than 120/80 mm Hg (millimeters of mercury). High blood pressure is 140 and higher for systolic. The diastolic does not need to be high for you to have high blood pressure. When that happens, the condition is called “isolated systolic hypertension,” or ISH.

Is Systolic High Blood Pressure Common?

Yes. It is the most common form of high blood pressure for older Americans. For most Americans, systolic blood pressure increases with age, while diastolic increases until about age 55 and then declines. About 65 percent of hypertensives over age 60 have ISH. You may have ISH and feel fine. As with other types of high blood pressure, ISH often causes no symptoms. To find out if you have ISH — or any type of high blood pressure — see your doctor and have a blood pressure test. The test is quick and painless.

Is Systolic High Blood Pressure Dangerous?

Any form of high blood pressure is dangerous if not properly treated. If left uncontrolled, it can lead to stroke, heart attack, congestive heart failure, kidney damage, blindness, or other conditions. While it cannot be cured once it has developed, ISH can be controlled.

Does It Require Special Treatment?

Treatment options for ISH are the same as for other types of high blood pressure, in which both systolic and diastolic pressures are high. ISH is treated with lifestyle changes and/or medications. The key for any high blood pressure treatment is to bring the condition under proper control. Blood pressure should be controlled to less than 140/90. If yours is not, then ask your doctor why. You may just need a lifestyle or drug change, such as reducing salt or adding a second medication.

Why Is The NHLBI Issuing A Clinical Advisory?

The National Heart, Lung, and Blood Institute (NHLBI) and the National High Blood Pressure Education Program (NHBPEP), which it coordinates, periodically issue clinical practice guidelines to help doctors better diagnose and manage their patients' high blood pressure. The last guidelines were released in 1997. Since then, scientific findings have shown that systolic blood pressure is the best indication of a middle-aged or older patient's need for treatment. The advisory is being issued to give doctors and their patients the latest information as quickly as possible.

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Last reviewed December 29, 2007