Isolated Systolic Hypertension

Commonly diagnosed, rarely treated

Isolated systolic hypertension is when your systolic blood pressure is too high, but diastolic blood pressure is normal. Your blood pressure is measured with two readings: a systolic value for when your heart contracts, and a diastolic value for when your heart relaxes. Both are usually recorded in millimeters of mercury, or mmHg. If your diastolic blood pressure is lower than 90 mmHg, within a normal range, but your systolic blood pressure is consistently higher than 150 mmHg, you may have isolated systolic hypertension.


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Leading up into old age, diastolic pressure steadily increases and it is this value that is used as an indicator of high blood pressure, but around the age of 65 diastolic blood pressure begins to decline while systolic blood pressure continues to increase. This means that the systolic value is best used to determine whether or not a person over 65 has hypertension, or more specifically, isolated systolic hypertension.

According to a major study from 2001, NHANES III, isolated systolic hypertension is the most common form of hypertension in adults over 65. Despite this, it is the least treated form of hypertension. According to the Journal of Human Hypertension, less than 10 percent of individuals with isolated systolic hypertension take medication for their condition.

As with most cases of high blood pressure, people with isolated systolic hypertension do not usually experience any symptoms.

Even without noticeable symptoms, isolated systolic hypertension still carries the same risks as other forms of high blood pressure. It increases your chance of having a stroke, heart attack, kidney damage and a variety of other health problems.

As mentioned earlier, isolated systolic hypertension is extremely prevalent in older adults yet often remains untreated. This does not mean there are no effective treatments. According to a study published in the Journal of the American Medical Association, anti-hypertensive medication reduced the risk of stroke by 36 percent for isolated systolic hypertension patients over 60. The commonly used drug ramipril, an ACE inhibitor, is not recommended for treating isolated systolic hypertension. Instead, an ARB such as Micardis should be taken to quickly and effectively lower blood pressure.

It's therefore important that you talk to your doctor and ask if treatment is appropriate if you discover that you have isolated systolic hypertension.