In isolated systolic high blood pressure (isolated systolic hypertension, or ISH), systolic blood pressure is elevated (130 mm Hg or higher), but diastolic blood pressure stays below 80 mm Hg. This type of high blood pressure is more common in older adults, especially older women. In fact, the majority of people older than 60 who have hypertension have isolated systolic hypertension.
Blood tests may be done to assess risk factors for heart disease and stroke as well as looking for complications of hypertension. These include complete blood count (CBC), electrolytes, BUN (blood urea nitrogen), and creatinine and GFR (glomerular filtration rate) to measure kidney function. A fasting lipid profile will measure cholesterol and triglyceride levels in the blood. If appropriate, blood tests may be considered to look for an underlying cause of high blood pressure (secondary hypertension)including abnormal thyroid or adrenal gland function.

Isolated systolic hypertension can be caused by underlying conditions such as artery stiffness, an overactive thyroid (hyperthyroidism) or diabetes. Occasionally, it can be caused by heart valve problems. It is the most common form of high blood pressure in people older than age 65, but it is possible for younger people to be affected by this type of high blood pressure as well.

Most doctors do not make a final diagnosis of high blood pressure until they measure your blood pressure several times (at least 2 blood pressure readings on 3 different days). Some doctors ask their patients to wear a portable machine that measures their blood pressure over the course of several days. This machine may help the doctor find out whether a patient has true high blood pressure or what is known as “white-coat hypertension.” White-coat hypertension is a condition in which a patient’s blood pressure rises during a visit to a doctor when anxiety and stress probably play a role.
Diabetes can upset the balance between HDL and LDL cholesterol levels. People with diabetes tend to have LDL particles that stick to arteries and damage blood vessel walls more easily. Glucose (a type of sugar) attaches to lipoproteins (a cholesterol-protein package that enables cholesterol to travel through blood). Sugarcoated LDL remains in the bloodstream longer and may lead to the formation of plaque. People with diabetes tend to have low HDL and high triglyceride (another kind of blood fat) levels. Both of these boost the risk of heart and artery disease.
As you get older, high blood pressure, especially isolated systolic hypertension, is more common and can increase your risk of serious health problems. Treatment, especially if you have other medical conditions, requires ongoing evaluation and discussions with your doctor to strike the best balance of reducing risks and maintaining a good quality of life.
LDL cholesterol: This is the “bad” type of cholesterol. Although your body needs a little bit of it to build cells, too much LDL can build up on the walls of your blood vessels over time, eventually blocking blood flow, which can lead to heart disease. When a doctor tests your blood for cholesterol levels, the more LDL there is, the higher your risk for heart disease.

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Kidney scarring (glomerulosclerosis). Glomerulosclerosis (gloe-mer-u-loe-skluh-ROE-sis) is a type of kidney damage caused by scarring of the glomeruli (gloe-MER-u-li). The glomeruli are tiny clusters of blood vessels within your kidneys that filter fluid and waste from your blood. Glomerulosclerosis can leave your kidneys unable to filter waste effectively, leading to kidney failure.
Blood pressure is the force of blood pushing against the walls of arteries. When the doctor measures your blood pressure, the results are given in two numbers. The first number, called systolic blood pressure, is the pressure caused by your heart contracting and pushing out blood. The second number, called diastolic blood pressure, is the pressure when your heart relaxes and fills with blood. Your blood pressure reading is usually given as the systolic blood pressure number over the diastolic blood pressure number, such as 138/72. Normal blood pressure for adults is defined as a systolic pressure of less than 120 and a diastolic pressure of less than 80. This is stated as 120/80.
Blood pressure isn’t just a number. Chronically elevated blood pressure (hypertension) significantly increases your risk of heart disease, stroke, congestive heart failure, erectile dysfunction, eye disease (retinopathy), and kidney disease. Heart disease and stroke are two of the top five causes of death in the US (heart disease is #1), and hypertension is such a big contributor to both that the CDC claims hypertension was at least partially responsible for 410,000 deaths in the US in 2014.
How do you check your own blood pressure? It is common to have your blood pressure checked at the doctor's office, but there are many cases where it is important to monitor it at home. It is easy to check blood pressure with an automated machine, but it can also be done manually at home. Learn how to check your own blood pressure and what the results mean. Read now
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