Shiva Shashidharan, MD
Orlando Health
There is a type of blood pressure that can be a significant threat to your health, but you might not have ever heard of it. And if you’re older, you’re at greater risk.
To understand isolated systolic hypertension, the lesser-known variety of high blood pressure, let’s start with the basics. Blood pressure is measured in two numbers, with one listed over the other, as in 120/80.
The top number reflects your systolic blood pressure – the force of blood moving through your arteries when you heart is squeezing. When that top number is over 120, your risk for heart disease and other health problems starts to increase.
The bottom number is your diastolic blood pressure – the force of blood moving through your arteries when your heart is relaxing. When that number gets above 80, it becomes a risk factor for various health problems.
You may be diagnosed with high blood pressure if your readings for either measure are consistently higher than the normal number.
Isolated systolic hypertension is a condition in which your bottom number is normal, but your top number is greater than 140. However, if you have a condition (diabetes or coronary artery disease, for example) that increases your risk for heart problems, you may be diagnosed with isolated systolic hypertension if your top number is higher than 130.
Symptoms of Isolated Systolic Hypertension
This is a major risk factor for heart disease, but one that often goes unnoticed unless you have your blood pressure checked regularly. High blood pressure is known as a silent killer. By the time most people begin to notice symptoms, they may already be at significant risk. Symptoms include:
- Blurred vision
- Chest pain
- Dizziness or lightheadedness
- Confusion
- Headaches
- Swelling in your legs
- Nausea
- Unexplained shortness of breath
- Snoring or sleep apnea
What Causes It?
As you age (particularly after 50), it’s common for your systolic number to increase as your blood vessels lose their flexibility. So isolated systolic hypertension is more often seen in the elderly, often around the age of 65.
We’re still learning more about its causes, but other potential risk factors include a sedentary lifestyle, eating a lot of salt and processed foods, diabetes, high cholesterol and smoking.
How Is It Treated?
The most important part of treatment is recognizing that you have hypertension. But just because you have a high blood pressure reading at your doctor’s office, that doesn’t necessarily mean you have high blood pressure.
One of the keys to diagnosis is getting readings at different times and in different settings. There is, for example, something known as “white coat hypertension,” where your blood pressure spikes whenever you are in doctor’s office or similar setting.
You can easily test your blood pressure at home, using a relatively inexpensive monitor that slips over your arm or wrist. To gain a more accurate understanding of your blood pressure, check it when you get up in the morning, before you go to bed and one other time during the day.
Fortunately, hypertension and isolated systolic hypertension can often be managed with a combination of strategies. Those include:
- Exercise: You should aim for 150 minutes of moderate-intensity exercise each week. Find something you enjoy doing, whether its bicycling, jogging, swimming, brisk walks or some other activity that gets your heart pumping.
- Lose weight: Even dropping 10 pounds can make a difference in your blood pressure.
- Cut back on salt: Ideally, you should limit salt intake to 1,500 mg per day.
- Modify your eating habits: Cut out processed food and red meats in favor of fruits, vegetables, whole grains and foods higher in fiber (legumes for example.)
- Medications: There are several types of medications, including calcium channel blockers and diuretics, which may be helpful when diet and lifestyle changes aren’t enough.
Source: Orlando Health, www.orlandohealth.com
