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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