Systolic Blood Pressure Key for Elderly.

• Position: Brief Article - Statistical Data Included

Blood pressure is typically recorded as two numbers--the systolic pressure (as the heart beats) over the diastolic pressure (as the heart relaxes between beats), in the past, many physicians relied on diastolic blood pressure to diagnose hypertension. However, research has found that diastolic blood pressure rises until about age 55 and then declines, while systolic blood pressure increases steadily with age.

"Systolic hypertension is a major health threat, especially for older Americans," cautions Claude Lenfant, director of the National Heart, Lung, and Blood Institute (NHLBI). "While it cannot be cured, systolic hypertension can be treated and its complications prevented. Americans may have heard that diastolic blood pressure counts more. That may be true for younger people. But we now know that, as people get older, systolic blood pressure becomes more important.... If you're middle-aged or older, it's a better blood pressure indicator than diastolic of your risk of heart disease and stroke."

Findings from NHLBI's long-term Framingham Heart Study of 5,000 persons showed that systolic blood pressure alone correctly identified 91% of those who may need antihypertensive therapy, while diastolic blood pressure alone correctly identified 22% of them. Among those over age 60, systolic blood pressure alone was even better able than diastolic pressure alone to classify blood pressure correctly.

For many older Americans, only the systolic blood pressure is high, a condition known as isolated systolic hypertension, or ISH (systolic at or above 140 and diastolic under 90). ISH is the most common form of high...