Systolic pressure is the force of blood in the arteries as the heart beats. It is shown as the top number in a blood pressure reading. High blood pressure is 140 and higher for systolic pressure. Diastolic pressure 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 isolated 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 isolated systolic high blood pressure dangerous?
Any form of high blood pressure is dangerous if not properly treated. Both numbers in a blood pressure test are important, but, for some, the systolic is especially meaningful. That’s because, for those persons middle aged and older, systolic pressure gives a better diagnosis of high blood pressure.
If left uncontrolled, high systolic pressure 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.
Clinical studies have proven that treating a high systolic pressure saves lives, greatly reduces illness, and improves the quality of life. Yet, most Americans do not have their high systolic pressure under control.
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 mmHg. If yours is not, then ask your doctor why. You may just need a lifestyle or drug change, such as reducing salt in your diet or adding a second medication.
Revision date: June 14, 2011
Last revised: by Sebastian Scheller, MD, ScD