What is the feature of isolated systolic hypertension

Medical statistics claim that in patients with hypertension of this type, complications in the work of the heart and blood vessels are more common, and the risk of death is also increased. With a relatively small increase in systolic blood pressure, the percentage of complications from the cardiovascular and brain activity increases markedly.

Most often, systolic hypertension is diagnosed in old age as one of the signs of aging, when the systolic blood pressure border exceeds 140 mmHg. Art., while diastolic blood pressure remains at the level of 90 mm. Hg. Art. and below. In addition to these criteria, the pulse pressure of the arteries is also important, since with the development of ISAG it always rises.

But this does not mean at all that other age categories are not familiar with high pressure. The causes of the disease are determined by hemodynamic factors and neurohormonal dysfunction.

In adulthood, arteries lose elasticity, accumulate calcium, collagen, elastin and glycosaminoglycans. With pressure drops, vessels with such baggage are not able to adequately respond to changes. Age-related changes are observed in the form of deterioration in the functioning of the kidneys, heart, blood vessels, impaired cerebral blood flow, low sensitivity of baro- and adrenoreceptors.

Systolic blood pressure is affected by an increase in atrial volume at the age of fifty, sclerosis, and decreased renal glomerular filtration.

Distinguish 2 forms of the disease:

  • Secondary ISAG, when the volume of the heart is above normal. It is accompanied by atrioventricular block, anemia, valve failure.
  • The primary (latent) form, when the causes of the increase in blood pressure are not defined.

Depending on the level of blood pressure, 4 degrees of ISAG are classified:

  1. The first is 140-160 mmHg. st .;
  2. The second – 160-180 mm RT. st .;
  3. The third – 180-210 mm RT. st .;
  4. Fourth – 210 mm RT. Art. and more.

Among the main reasons that provoke the development of the disease, we can distinguish:

  • Unbalanced diet (fatty and salty foods are a particular threat).
  • Significant excess of body weight. This factor is a consequence of the first reason. A lot of weight requires an appropriate amount of blood. For normal blood supply, the vessels should also increase, but they do not expand, as they have lost their elasticity. This leads to increased pressure.
  • Deficiency of trace elements and minerals: in particular, potassium and magnesium are necessary for the normal functioning of the heart muscle. The first helps to remove excess salt, the second – prevents the formation of blood clots, strengthens the blood vessels of the heart.
  • Inadequate physical activity. If the vessels are not active, they lose their tone and in critical situations are not able to respond adequately.
  • Regular smoking not only increases the risk of blood clots – it affects the functioning of blood vessels. A healthy vessel stretches with an increase in blood volume, while under the influence of nicotine it behaves exactly the opposite.
  • Frequent stresses are especially dangerous if the patient reacts to them incorrectly, trying to relieve stress by a cigarette, alcohol or sweets.
  • Genetic tendency is manifested in the form of anatomical features that complicate blood circulation.
  • The unfavorable ecological situation, characteristic of the inhabitants of industrial regions and megacities, increases the number of hypertensive patients.
  • Concomitant diseases – diabetes mellitus, renal or liver failure can increase blood pressure.

Many hypertensive patients do not feel an increase in systolic pressure, therefore they do not take any measures. Others have complaints about common symptoms: headache, dizziness, and tinnitus. Signs are mild.

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Some patients already with a slight change in pressure note deterioration of vision and memory, pain in the heart and head, poor coordination. Such patients are familiar with hypertensive crises, characterized by a sharp increase in blood pressure with an increase in clinical signs.

Increased systolic blood pressure can last a long time, but sometimes it drops sharply without medical intervention. Symptoms of this type of hypertension can complement brain, kidney, and coronary disorders. High blood pressure provokes complications of heart disease until death.


To establish an objective picture, different diagnostic methods are used. First of all, the doctor talks with the patient, clarifying not only complaints about the current state, but also the features of the course of all his previous illnesses. This helps the doctor evaluate all risk factors.

After the consultation, a physical examination is performed. With the help of a phonendoscope, an abnormal noise in the heart is heard, a change in its tone, helping to determine any deviations.

The most popular diagnostic method is an electrocardiogram. Electric heart potential for a certain period of time is recorded on a special tape. Decoding the ECG allows you to identify heart rhythm failures, ventricular hypertrophy, confirming the diagnosis of “arterial hypertension.”

Other research methods:

  • Echocardiography helps to detect defects in the structure of the heart, assess the condition of the valves, check the change in wall density.
  • Dopplerography allows you to explore the circulatory system. With arterial hypertension, it is important to monitor the condition of the carotid and cerebral arteries.
  • A biochemical blood test gives a clear idea of ​​the level of cholesterol and blood sugar.
  • A comprehensive examination allows you to make an accurate diagnosis in order to prescribe an adequate treatment.

When is “isolated systolic hypertension” diagnosed?

If, during the last three visits to the doctor, the average systolic pressure is greater than 140 mm Hg. Art. with normal data of the diastolic level, we can talk about the development of ISAG. In adulthood, when measuring blood pressure, air is pumped into the chamber up to 250 mm Hg. Art. and slowly let him down. The patient should be in a standing or sitting position.

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For an objective picture, measurements are carried out on both hands. If ISAG is diagnosed after 60 years or is difficult to treat, it is necessary to exclude secondary hypertension, which provokes atherosclerosis of the renal arteries.

ISAG in young people

The question of an isolated increase in systolic blood pressure at a young age remains open, since the accumulated statistics do not allow an unambiguous conclusion. According to the results of research by American scientists, girls and young people with a diagnosis of “ISAG” were more likely to die from ischemic (CHD) and other heart diseases than their peers with normal pressure.

The average age of a group of volunteers selected from the Caucasian race was 34 years. At risk, more disturbing results were found in women. ISAH patients are more likely to smoke and have a low educational level. Their body mass index and cholesterol level were higher than the control group.

If the pressure indicators are stable, doctors are advised to intervene more aggressively and, first of all, with the help of lifestyle correction. Until recently, the blood pressure indicators characteristic of ISAG did not even try to be corrected, believing that any treatment would give more side effects than efficacy.

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ISAG in adulthood

In the treatment of ISAG, patients of retirement age require a special approach, because in addition to high blood pressure, they usually have a whole bunch of other diseases. At the time of diagnosis, many of them are taking different drugs, the combined effect of which, when the complex is added to normalize, blood pressure can give a negative result.

If an elderly patient has memory loss or difficulty concentrating among ISAH symptoms, he will not be able to follow the prescribed medication regimen at home without assistance.

Problems with blood vessels can cause such a specific phenomenon as postural hypertension. Only a doctor can distinguish pseudohypertension from ISAG – this can be an additional argument against proponents of self-medication, who choose medications and doses at their own risk.

Isolated systolic hypertension – treatment

First of all, the patient must take control of his lifestyle:

  • Get rid of excess weight;
  • Revise your diet to reduce salt and animal fats;
  • Master the technique of muscle relaxation;
  • Dose physical activity;
  • Monitor compliance with sleep and rest.

When choosing drugs, the doctor should take into account the patient’s age and hemodynamic mechanisms. These criteria are especially important in the treatment of mature patients in whom hypertension can take many forms.

Medication Therapy

ISAG can be treated with special antihypertensive therapy, the safety and effectiveness of which can only be guaranteed by a doctor.

At the initial treatment, beta-blocker inhibitors, calcium antagonists, sartans and ACE are prescribed. Experience shows that this complex gives a positive result regardless of the age of the patient. It helps reduce the risk of ISAG and disease-related complications.

The elasticity of the arteries is increased with the help of vasoactive drugs, which also reduce their tone. Blood pressure drops at the time of ejection of blood from the left ventricle. With the constant intake of diuretics, the plasma volume and volumetric heart beat decrease.

To select the exact dosage, you need to regularly monitor blood pressure. The correct indicators on the tonometer can be seen if you measure pressure on an empty stomach, sitting or lying down.

At the initial stage of treatment, the pressure should decrease by 30 percent. This will help prevent impairment of cerebral and renal functions. They also control carbohydrate and electrolyte metabolism. In Europe, an ACE inhibitor is often prescribed in parallel with hydrochlorothiazide.

In addition to a comprehensive examination and adequate therapy, it is important to remember that the state of our cardiovascular system largely depends on the quality of life, which we ourselves must monitor.

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Tatyana Jakowenko

Editor-in-chief of the Detonic online magazine, cardiologist Yakovenko-Plahotnaya Tatyana. Author of more than 950 scientific articles, including in foreign medical journals. He has been working as a cardiologist in a clinical hospital for over 12 years. He owns modern methods of diagnosis and treatment of cardiovascular diseases and implements them in his professional activities. For example, it uses methods of resuscitation of the heart, decoding of ECG, functional tests, cyclic ergometry and knows echocardiography very well.

For 10 years, she has been an active participant in numerous medical symposia and workshops for doctors - families, therapists and cardiologists. He has many publications on a healthy lifestyle, diagnosis and treatment of heart and vascular diseases.

He regularly monitors new publications of European and American cardiology journals, writes scientific articles, prepares reports at scientific conferences and participates in European cardiology congresses.