Isolated systolic hypertension

Isolated Systolic Hypertension

Isolated Systolic Hypertension (ISH) is a form of hypertension characterized by elevated systolic blood pressure (SBP) with normal diastolic blood pressure (DBP). It is a common condition, particularly in older adults, and is associated with increased risk of cardiovascular disease.

Pathophysiology

ISH occurs when the systolic blood pressure is elevated (≥ 140 mmHg) while the diastolic blood pressure remains below 90 mmHg. This condition is primarily due to the stiffening of the large arteries, such as the aorta, which occurs with aging. As the arteries become less compliant, the heart must exert more force to pump blood through the body, leading to increased systolic pressure.

Risk Factors

Several factors contribute to the development of ISH, including:

• Age: The prevalence of ISH increases with age, particularly in individuals over 60 years old.
• Genetics: A family history of hypertension can increase the risk.
• Lifestyle factors: Poor diet, lack of physical activity, and excessive alcohol consumption can contribute to the development of ISH.
• Obesity: Excess body weight is a significant risk factor for hypertension.

Diagnosis

ISH is diagnosed through regular blood pressure monitoring. A diagnosis is made when multiple readings show a systolic blood pressure of 140 mmHg or higher, with a diastolic pressure below 90 mmHg. It is important to measure blood pressure accurately, using a properly calibrated sphygmomanometer and following standardized procedures.

Complications

If left untreated, ISH can lead to serious health complications, including:

• Stroke
• Heart attack
• Heart failure
• Chronic kidney disease

Management

The management of ISH involves lifestyle modifications and, if necessary, pharmacological treatment. Key strategies include:

• Lifestyle changes: Adopting a healthy diet, such as the DASH diet, increasing physical activity, reducing alcohol intake, and quitting smoking.
• Medications: Antihypertensive medications, such as thiazide diuretics, calcium channel blockers, and ACE inhibitors, may be prescribed to help control blood pressure.

Prognosis

With appropriate management, individuals with ISH can significantly reduce their risk of cardiovascular complications. Regular monitoring and adherence to treatment plans are crucial for maintaining optimal blood pressure levels.

Also see

• Hypertension
• Systolic blood pressure
• Diastolic blood pressure
• Cardiovascular disease