Is having a high top number (systolic) blood pressure, but an OK bottom number (diastolic) cause for concern?Answer From Sheldon G. Sheps, M.D. Show
Yes. If systolic blood pressure rises but diastolic blood pressure stays within an acceptable range, the condition is called isolated systolic hypertension. Isolated systolic hypertension happens when the diastolic blood pressure is less than 80 millimeters of mercury (mm Hg) and the systolic blood pressure is 130 mm Hg or higher. Isolated systolic hypertension is the most common form of high blood pressure in people older than age 65. Younger people can have this type of high blood pressure too. Isolated systolic hypertension can be caused by conditions such as:
Having a high systolic blood pressure over time can increase the risk of strokes, heart disease and chronic kidney disease. The recommended goal for systolic pressure for adults younger than age 65 who have a 10% or higher risk of developing cardiovascular disease is less than 130 mm Hg. For healthy adults who are age 65 or older, the recommended treatment goal for systolic pressure is also less than 130 mm Hg. Controlling isolated systolic hypertension to prevent health problems requires medication. But it's important that the treatment to lower systolic blood pressure doesn't cause the diastolic blood pressure to drop too low. That can cause other complications. In addition to medication, lifestyle changes can help improve the systolic blood pressure reading. Important changes include:
Your health care provider will ask you to come back for a follow-up appointment to make sure your treatment and lifestyle changes are improving your blood pressure. Sign up for free, and stay up to date on research advancements, health tips and current health topics, like COVID-19, plus expertise on managing health. To provide you with the most relevant and helpful information, and understand which information is
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. Is the top or bottom blood pressure number most important?For years, systolic blood pressure has been seen as the one that really matters. That's based on studies -- including the famous Framingham Heart Study -- showing that high systolic blood pressure is a stronger predictor of heart disease and stroke.
Why is diastolic more important than systolic?The bottom number is your diastolic blood pressure, it's the lowest level your blood pressure reaches between beats. The top number is more important because it gives a better idea of your risk of having a stroke or heart attack.
Is low systolic or diastolic more important?In this review we compare the relative importance of various blood pressure components. Recent findings: Generally, in studies in which readings of systolic and diastolic blood pressure have been compared, systolic blood pressure has been a better predictor of risk.
When should you worry about the bottom number of blood pressure?Over time, isolated diastolic hypotension can cause heart failure. In fact, it may be one of the most common causes of heart failure. Pay attention to your diastolic number when you have your blood pressure checked. If your lower number is 60 or below, ask a healthcare professional about it.
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