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Back To Vidyya Study In Hypertension Highlights Importance Of Systolic Blood Pressure Control

Physicians And Patients Encouraged To Focus On Systolic Blood Pressure To Reduce Cardiovascular Risk

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.

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Editor: Susan K. Boyer, RN
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