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Only My Systolic Blood Pressure is High, Do I Need Treatment?


Updated February 06, 2008

Question: Only My Systolic Blood Pressure is High, Do I Need Treatment?

Yes, though the treatment options vary. This is most likely just a variation of “regular” high blood pressure. Everyone’s body is a little different, and it is not uncommon for patients to have one number (systolic or diastolic) that is more elevated than the other. Some people have elevated systolic pressure but normal, or even below normal diastolic pressure. It is also possible to have an elevated diastolic pressure with a normal systolic pressure, though this is less common.

A condition called isolated systolic hypertension, where the systolic pressure rises and the diastolic pressure stays close to normal. Isolated systolic hypertension usually affects older people and is the result of a very clear and known disease process somewhere else in the body.

While there is no universal rule, a good rule of thumb to consider is that the systolic pressure in isolated systolic hypertension is usually very high, often close to 200. If your systolic pressure is elevated and your diastolic pressure is not, that doesn’t mean you have isolated systolic hypertension. It most likely means you have “ordinary” high blood pressure. Your doctor will be able to tell for sure.

Because cases where one number is more elevated over baseline than the other number usually represent standard hypertension, the treatment options are the same. In cases of true isolated systolic hypertension, the treatment options are different, and usually several treatments are tried at the same time.

If you’ve noticed your blood pressure readings show this “one is elevated, one is not” pattern, tell your doctor. He can run different tests to make sure that there is not some other, underlying problem that needs to be addressed. Depending on your personal medical history, figuring this out might go quickly, or it may take a bit of time as your doctor builds up a blood pressure record and checks for any underlying disease.

Related: Special Types of High Blood Pressure

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