What is isolated systolic hypertension?

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What is isolated systolic hypertension?

Isolated Systolic Hypertension (ISH) is a specific type of high blood pressure (hypertension) where only the systolic blood pressure (the top number in a blood pressure reading) is elevated, while the diastolic blood pressure (the bottom number) remains within the normal range.

Key Characteristics:

Systolic BP: 130 mmHg or higher
Diastolic BP: Less than 80 mmHg

Why Does This Happen?

ISH often occurs due to changes in the cardiovascular system, particularly in older adults. As people age, arteries can become stiffer and less elastic, causing the systolic pressure to rise while diastolic pressure stays stable or even decreases.

Causes:

Aging: Loss of arterial elasticity and stiffening of large arteries.
Atherosclerosis: Build-up of plaque in arteries, reducing their flexibility.
Hyperthyroidism: Overactive thyroid gland.
Heart valve issues: Conditions like aortic valve regurgitation.
Kidney disease: Impaired ability to regulate blood pressure.
Lifestyle factors: Sedentary lifestyle, poor diet, and high sodium intake.

Symptoms:

ISH often does not produce noticeable symptoms. However, in severe cases or over time, it may lead to:

Headaches
Dizziness
Vision changes
Shortness of breath
Chest pain (in extreme cases)

Risks Associated with ISH:

Unchecked ISH can increase the risk of:

Heart disease: Including left ventricular hypertrophy.
Stroke: Due to increased pressure on blood vessels in the brain.
Kidney damage: Resulting from prolonged high systolic pressure.
Aneurysms: Weak spots in arteries that can rupture.

Treatment:

Treatment for ISH aims to reduce systolic blood pressure while avoiding overly lowering diastolic pressure, which could impair blood flow to vital organs. Common approaches include:

Lifestyle Changes:
- Diet: Adopting the DASH (Dietary Approaches to Stop Hypertension) diet.
- Exercise: Regular aerobic activity to improve cardiovascular health.
- Salt Reduction: Limiting sodium intake to lower blood pressure.
- Weight Management: Reducing excess weight to alleviate strain on the heart.
Medications:
- Diuretics: To reduce fluid retention and lower pressure.
- Calcium Channel Blockers: To relax blood vessels.
- ACE Inhibitors or ARBs: To improve blood vessel function.
- Beta-blockers: Occasionally used for specific cases.

Who Is at Risk?

Older adults (especially those over 60)
People with a family history of hypertension
Individuals with unhealthy lifestyle habits

Early detection and management of ISH can significantly reduce the risk of complications and improve overall cardiovascular health. Regular blood pressure monitoring and medical check-ups are essential.