What Is Systolic Hypertension?

B. Chisholm

Systolic hypertension refers to a high systolic blood pressure. Blood pressure is normally referred to as systolic blood pressure over diastolic blood pressure, measured in millimeters mercury (mmHg). While the definition of normal blood pressure differs from country to country, it is typically around 120/80 mmHg. In other words, normal systolic blood pressure is around 120 mmHg. Generally speaking, a systolic blood pressure above 140 mmHg would be termed systolic hypertension.

Isolated systolic hypertension is very common, particularly among older adults.
Isolated systolic hypertension is very common, particularly among older adults.

Blood pressure is a vital factor for life. Circulation of blood throughout the body and its return through the heart depends on this pressure. If it drops too low or goes too high, essential bodily functions may fail. The systolic blood pressure is the maximum pressure during a heartbeat. A commonly found form of hypertension is called isolated systolic hypertension. This occurs when the systolic blood pressure is high, but diastolic is normal or low.

Medication may be necessary to treat cases of severe systolic hypertension.
Medication may be necessary to treat cases of severe systolic hypertension.

In the past, doctors were concerned only with raised diastolic pressure and paid little attention to systolic hypertension, but now it is known that systolic hypertension, too, may have adverse effects on the body. Treatment of systolic hypertension is now routine. The challenge in the treatment of isolated systolic hypertension lies in not lowering the diastolic pressure too much at the same time, as this too may have deleterious effects.

Isolated systolic hypertension is extremely common, especially in older patients. It may result from underlying conditions such as thyroid problems or leaky heart valves, or just be a result of age-related changes in the physiology of the heart. The first step in treatment is lifestyle changes, as these can go a long way to maintaining heart health. Lifestyle changes include exercise, eating healthily, stopping smoking and reducing the intake of alcohol.

Medication may be necessary, depending on the severity of the systolic hypertension. A number of different anti-hypertensive drug classes are available, and a doctor can prescribe the most suitable one or combination of them. Concomitant clinical conditions, drugs, allergies and the patient's tolerance and response may affect this choice. Dosage adjustment may be necessary initially to get adequate control of systolic blood pressure, without lowering diastolic pressure too much.

Some of the medications may cause adverse side effects. Should these occur, they should be discussed with the prescribing doctor. Dosages may need to be adjusted or a different class of drug may be necessary. Untreated systolic hypertension may result in ischemic heart disease, heart failure or stroke. Lifestyle changes should be made and prescribed medication taken to prevent these potentially fatal long-term effects.

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