A study published today in the March issue of Hypertension: Journal of the American Heart Association, conducted by the University of California, Irvine, indicates that most people age 50 and older who suffer from high blood pressure have elevated systolic blood pressure (top number), but normal diastolic blood pressure (bottom number) -- a condition known as isolated systolic hypertension (ISH). These results suggest that physicians and patients need to increase emphasis on systolic blood pressure in the management of hypertension.
High blood pressure, or hypertension, which affects more than 50 million
Americans, is defined in adults as blood pressure greater than or equal to 140
mm Hg systolic or greater than or equal to 90 mm Hg diastolic. In ISH, the
systolic blood pressure reading is elevated, while the diastolic reading is
normal. ISH places millions of people worldwide at risk of heart attack,
heart failure, stroke, and death.
The University of California, Irvine study, led by Dr. Stanley S.
Franklin, found that 80 percent of participants with hypertension age 50 and
older suffered from ISH.
"Achieving target blood pressure goals of 140/90 or less can help people
live longer and healthier lives," says Stanley S. Franklin, M.D., professor of
medicine, University of California, Irvine. "Previously, focus was placed on
diastolic blood pressure control in preventing cardiovascular risk. This
study contributes to the developing body of research emphasizing the
importance of controlling systolic blood pressure."
Diastolic readings measure blood pressure when the heart is at rest.
Systolic readings measure pressure when the heart contracts to pump blood
through the body.
These findings resulted from an analysis of nearly 20,000 individuals who
took part in the National Health and Nutrition Examination Survey (NHANES III)
conducted by the National Institutes of Health from 1988 to 1994. Of the
participants with hypertension, almost three-quarters (74 percent) were 50
years and older.
The study also revealed that 24 percent of the participants suffered from
hypertension. Only about one-quarter (27 percent) of the hypertensive study
participants were treated to the recommended blood pressure goals of 140/90.
And surprisingly, nearly half (48 percent) of the hypertensive study
participants were not treated for their condition at all.
"Hypertension can be successful managed," says Dr. Franklin. "Better
awareness and more aggressive antihypertensive therapy is urgently needed to
help manage this condition."
This study is part of Franklin's ongoing research on cardiovascular
disease, currently the leading cause of death in the United States. He and
his colleagues are continuing to look for ways to detect the risk of
cardiovascular disease as well as methods of preventing hypertension.
Franklin's co-workers on the study were Nathan D. Wong, Ph.D., director of
UCI's Heart Disease Prevention Program, Milagros J. Jacobs, a research
assistant at UCI and Gilbert J. L'Italien, Ph.D. and Pablo Lapuerta, M.D.
researchers at Bristol-Myers Squibb Company.