Navigation Links
Tracking Top Number in Blood Pressure May Be Enough
Date:6/17/2008

For those over 50, high systolic pressure is by far the greater threat, experts say

TUESDAY, June 17 (HealthDay News) -- For patients over 50, doctors tracking hypertension may only need to monitor systolic blood pressure, ignoring diastolic blood pressure, British experts suggest.

Systolic blood pressure -- the top number in a reading -- is the pressure exerted at the beginning of the heart's pumping cycle, while diastolic pressure records the lowest pressure during the heart's resting cycle. Both pressures are routinely measured when taking blood pressure.

"We felt that trying to communicate two pressures to patients is a very confusing message," said Dr. Bryan Williams, a professor of medicine at the University of Leicester and Leicester Royal Infirmary, U.K., and co-author of a Viewpoint article in the June 17 online issue of The Lancet.

"If we could just get patients to focus on a single number, and recognize that that number needed to be lowered, it might help in both communicating the message and also improving treatment," Williams said.

Because there is such an emphasis on diastolic pressure, patients are not getting their systolic blood pressure adequately controlled, Williams contends. "We felt the best way of dealing with this was to say that people over the age of 50 probably didn't even need to measure diastolic -- it's only the systolic we should be focusing on," he said.

Some experts in the United States have long pushed for the change. In 2000, a National Institutes of Health-sponsored group published an advisory in the journal Hypertension that supported a clinical focus on systolic pressure.

As the population ages, a rise in systolic pressure resulting in what is called systolic hypertension is becoming more common, especially in people over 50, compared with diastolic hypertension, Williams noted.

Generally, systolic blood pressure continues to increase with age, while diastolic pressure starts to drop after age 50, which is the same time cardiovascular risk begins to rise. Therefore, there is an increased prevalence of systolic hypertension past age 50, whereas diastolic hypertension is practically nonexistent.

"It's pretty pointless to measure diastolic pressure, since it's falling anyway," Williams said. "Rising systolic pressure is the most significant factor in causing strokes and heart disease," he said. "That's what we need to be focusing on."

Using systolic blood pressure alone after age 50 should simplify treatment for doctors, policymakers and even drug companies by getting them to focus on ways to lower systolic pressure, Williams said.

Using systolic pressure alone focuses physicians' attention on what needs to be treated, since many may still be using diastolic pressure to guide treatment decisions, Williams said.

For people under 50, the scenario may be different. About 40 percent of adults under 40 years of age have diastolic hypertension, and about a third of those between 40 and 50 have the problem. For these patients, there needs to be a continued emphasis on both systolic and diastolic blood pressures, Williams's group said. However, controlling systolic blood pressure, even among these younger patients, almost always results in adequate control of diastolic blood pressure, too, they noted.

But one expert believes that there are still important reasons to concentrate on systolic and diastolic blood pressure for patients of any age.

"Inadequate control of hypertension contributes to a substantial proportion of preventable cardiovascular events worldwide," said Dr. Gregg C. Fonarow, director of the Ahmanson-UCLA Cardiomyopathy Center at the University of California, Los Angeles. "Elevations in systolic as well as diastolic blood pressure contribute to this cardiovascular risk, although in patients over age 50, elevations in systolic blood pressure impart greater relative risk," he said.

The proposal in this Viewpoint to only use systolic hypertension for the diagnosis and treatment of hypertension in patients age 50 and over, while thought-provoking and having the laudable aim to improving treatment and control of systolic blood pressure, may have unintended consequences that require further consideration, Fonarow said.

"Gains made in achieving better control of diastolic blood pressure in the last few decades may be lost if the sole focus of hypertension guidelines becomes systolic blood pressure," Fonarow said. "Studies have suggested that drops in diastolic blood pressure to very low levels may increase cardiovascular risk for patients with coronary artery disease; under this single dimension proposal, this risk could be obscured," he said.

"Furthermore, measurement of both systolic and diastolic blood pressure are essential components of global cardiovascular risk assessment using the Framingham and other risk assessment scores, hence the need to retain routine diastolic blood pressure measurement," Fonarow said.

More information

For more about high blood pressure, visit the American Heart Association.



SOURCES: Bryan Williams, M.D., professor, medicine, University of Leicester and Leicester Royal Infirmary, U.K.; Gregg C. Fonarow, M.D., director, Ahmanson-UCLA Cardiomyopathy Center, University of California, Los Angeles; June 17, 2008, early online edition, The Lancet


'/>"/>
Copyright©2008 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. Tracking Cancer Drugs Effectiveness
2. Baxa Launches Microsite Featuring the MedBoard(TM) Medication Tracking System
3. Tracking and feedback registry helps reduce disparities in breast cancer care
4. Polar, Virgin HealthMiles Partnership Adds Heart Rate Tracking to Employee Health Incentive Program
5. Ekahau Offers Clear Visibility Into Real-Time Location Tracking With Ekahau Vision
6. Four Rivers Software Systems and ECRI Institute Announce New, Real-Time Interfaces to Improve Inventory Management and Patient Safety Alert and Recall Tracking
7. AT4 wireless and Ekahau Partner to Deploy Combined Asset and Staff Tracking Solution for Hospitals
8. AT&T Delivers Benefits of RFID Inventory Tracking to Health First
9. Tracking your carbon footprint
10. KLAS Ranks TeleTracking Bed Management Suite No. 1
11. Breaking Studies at AARC Congress Show Masimo SET and Masimo Rainbow SET to be Accurate, Effective and Uniquely Beneficial in Detecting and Tracking Disease States
Post Your Comments:
*Name:
*Comment:
*Email:
Related Image:
Tracking Top Number in Blood Pressure May Be Enough
(Date:12/8/2016)... ... 2016 , ... After enjoying record-breaking attendance at its last ... 33rd Annual Issues & Research Conference, March 2-3, 2017, at the Westin ... is “Persistent Challenges and New Opportunities: Using Research to Accelerate the Dialogue." 2016 ...
(Date:12/8/2016)... ... ... CURE Media Group, the nation’s leading digital and print media enterprise focused on ... efforts to combat lung cancer, announced CURE Media Group President Michael J. Hennessy, Jr. ... honored to team up with Upstage Lung Cancer in order to make major strides ...
(Date:12/8/2016)... (PRWEB) , ... December 08, ... ... Presence Suite 10.2 version gives development continuity to its innovative Unified Instance ... channels management capacity. In addition, this new version optimizes the unattended auto-dialing ...
(Date:12/8/2016)... Peachtree City, Ga (PRWEB) , ... December 08, ... ... and moving as soon after surgery as possible. With this in mind, SIGVARIS ... vein thrombosis (DVT or blood clot) during bed rest and provide the benefits ...
(Date:12/8/2016)... ... December 08, 2016 , ... The ... offices headquartered in Jefferson County, is announcing the launch of a charity drive ... The number of homeless women and children in Birmingham has grown steadily since ...
Breaking Medicine News(10 mins):
(Date:12/8/2016)... 8, 2016  Diplomat Pharmacy, Inc. (NYSE: DPLO) has been recognized ... Top Workplaces National Standard. To learn more about ... ... Inc.) ... survey administered by WorkplaceDynamics, LLC, a research firm specializing in organizational ...
(Date:12/8/2016)... Research and Markets has announced the addition ... Adhesion Type, Application, Usability - Forecast to 2025" report to ... , , ... poised to grow at a CAGR of around 3.2% from 2015 ... witnessing include advancements in extracellular microelectrode arrays and intracellular microelectrodes, research ...
(Date:12/8/2016)... Dec. 8, 2016  Pennsylvania Physician General Dr. ... and Alcohol Programs Gary Tennis released ... known as benzodiazepines, developed with the help of ... medications that are frequently prescribed for anxiety or ... used with opioid pain medications, benzodiazepines pose a ...
Breaking Medicine Technology: