Systolic hypertension (SH) refers to an elevation in the systolic blood pressure while the diastolic blood pressure is normal or low.
Synonym: isolated systolic hypertension (ISH)
Criteria:
(1) elevation of the systolic blood pressure
(1a) Stage 1: 140 to 159 mm Hg
(1b) Stage 2: >= 160 mm Hg
(2) diastolic blood pressure <= 90 mm Hg
Most patients with systolic hypertension are older adults. It 5% of adults in the US at age 60 and 24% at age 75.
Complications:
(1) transient ischemia attacks (TIA) and stroke
(2) coronary artery disease
(3) congestive heart failure
(4) renal disease
The goal is to control the systolic blood pressure without adverse effects on the patient. Appropriate therapy can significantly reduce SH complications in the elderly.
Complications from aggressive management:
(1) orthostatic hypotension
(2) fall-related injury
(3) impaired perfusion of coronary and/or cerebral arteries
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