What Is Isolated Systolic Hypertension?

One is said to have hypertension if he or she has a blood pressure of 140/90 mmHg or higher. 140 is the systolic blood pressure, the force on the arteries as the heart pumps blood, and 90 is the diastolic blood pressure, the force on them when the heart is resting.

Hypertension or more commonly known as high blood pressure can put extra strain on blood vessels and organs including the brain, kidneys and eyes. People with hypertension are at a higher risk of developing several chronic diseases including heart disease, stroke and kidney disease.

For some people, the systolic stays consistently at 140 or higher but the diastolic number is below 90, which is not in a hypertension range. The condition is called isolated systolic hypertension (ISH), which is the most common subtype of primary hypertension in people over the age of 50, as reported in a March 2015 article in ‘Journal of the American Society of Hypertension’. Primary hypertension, also known as essential hypertension, means there is no underlying medical condition to explain the hypertension. 

In the United States, it is currently estimated that more than 30 percent of women over 65 and more than 20 percent of men have ISH. People with a family history of hypertension are more likely to have it as they get older. It is also possible for younger people to be affected by ISH.

A study by doctors from UT Southwestern Medical Centre’s Hypertension program found that otherwise healthy young people aged 18 to 49 with ISH are at greater risk for future artery stiffening linked to an increased risk of stroke and possible damage to the kidneys and brain. The study, which was published May 15, 2017 in the journal ‘Hypertension’, examined 2,001 participants in the Dallas Heart Study, a population-based study of more than 6,000 adults in Dallas County in USA. The researcher also warned that the occurrence of ISH in Americans aged 18 to 39 more than doubles over the last 2 decades.

While the cause may not be completely understood, ISH is believed to be associated with 

age-related stiffening of the aorta (the main artery in the body) and narrowing of the smaller arteries. These changes cause the heart pump blood more forcefully through these vessels, increasing the systolic pressure. Other possible reasons include increased age, smoking, excess dietary sodium, alcohol abuse, obesity and inactivity.

There are very few initial symptoms, but as the condition worsens, symptoms may start to emerge. People with ISH may develop symptoms pain in the joints of the hands, racing heartbeat, dry eyes, blurry vision, leg cramps, sore throat, nocturia (nighttime urination), headaches and irregular heartbeat.

Medicine may need to be prescribed to bring the blood pressure down if the systolic blood pressure is too high. Some drugs used to control blood pressure may include diuretics (water pills) to help remove water and sodium from the body; beta-blockers to slow the heart beat and make the heart beat less forcefully; angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blockers (ARBs), or calcium channel blockers to relax the blood vessels; renin inhibitors to keep the kidneys from making a chemical that can lead to higher blood pressure.

Besides taking medications, patients may also be required to stop smoking if they are smokers, lower the amount of salt in the diet, cut back on alcohol for drinker, get to or stay at a healthy weight, and of course, exercise regularly.