In isolated systolic high blood pressure (isolated systolic
hypertension, or ISH),
systolic blood pressure is elevated (above 140 mm Hg),
but
diastolic blood pressure stays below 90 mm Hg. This
type of high blood pressure is more common in older adults, especially older
women. In fact, the majority of people older than 60 who have hypertension have
isolated systolic hypertension.1
If you are older than 50, a systolic blood pressure over 140 mm Hg is
a more important risk factor for stroke and heart disease than your diastolic
blood pressure.2
ISH can cause damage to organs such as the kidneys, brain, heart, or
eyes and should be treated. A major study (SHEP) determined that treatment of
ISH resulted in a 27% decrease in heart disease and a 36% decrease in
stroke.1, 3
An observational study has shown that those with
diabetes who have a lower systolic blood pressure also
have a lower risk of diabetic complications, such as
stroke and heart disease.4
Treatment of ISH often begins with the use of a
diuretic, which seems to be effective in older people.
Other medicines that may be used include long-acting
calcium channel blockers,
beta-blockers, or angiotensin-converting enzyme (ACE)
inhibitors.
The Dietary Approaches to Stop Hypertension (DASH) diet is effective
for treating isolated systolic hypertension.5