Systolic
hypertension is a major health threat, especially for older Americans. For many
years, we have been taught that diastolic blood pressure counts more. That may
be true for younger people. But we now know that, as people get older, systolic
blood pressure becomes more important. If you're middle aged or older, systolic
blood pressure is a better blood pressure indicator than diastolic of your risk
of heart disease and stroke, which are the first-and third-leading causes of death
among Americans. High blood pressures can lead to other conditions, such as congestive
heart failure, kidney damage, dementia and blindness. While it cannot be cured,
systolic hypertension can be treated and its complications prevented.
High
blood pressure or hypertension, affects 50 million Americans-one in four adults.
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. When a person has a reading
above 140/90, he is considered to have high blood pressure.
In the past,
many physicians relied on diastolic blood pressure to diagnose hypertension. But
research has found that diastolic blood pressure rises until about age 55 and
then declines, while systolic blood pressure increases steadily with age. For
many older Americans, only the systolic blood pressure is high, a condition known
as isolated systolic hypertension (ISH) with a systolic reading at or above 140
mm Hg and diastolic reading under 90 mm Hg. In fact, for older Americans, ISH
is the most common form of high blood pressure. Sixty five percent of all hypertensives
older than age 60 have ISH. Unfortunately, many older Americans have the poorest
hypertension control rate. For example, in hypertensives older than age 70, only
25 percent of African-Americans and only 18 percent of white Americans have their
blood pressure under control, below 140/90 mm Hg.
Controlling ISH significantly
reduces the risk of having a heart attack, heart failure or a stroke. As with
other types of high blood pressure, ISH often triggers no symptoms. To find out
if you have ISH-or any type of high blood pressure-see your doctor and have your
blood pressure checked regularity.
Treatment options for ISH are the same
as for other types of high blood pressure, in which both systolic and diastolic
pressures are high. The key for the treatment of ISH is to bring the blood pressure
under control, to less than 140/90. You may even achieve that goal by a lifestyle
or drug change, such as reducing salt, losing weight or adding a second medication.
No one has to put his or her health at risk from uncontrolled systolic hypertension.
Treatment for hypertension must begin early to prevent organ damage-whatever the
patient's age.
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