Tracking Top Number in Blood Pressure May Be Enough

HealthDay News is reporting a suggestion from British experts that for patients over 50, doctors tracking hypertension may only need to monitor systolic blood pressure (the upper number of the blood pressure), while ignoring diastolic blood pressure (the lower number).

In their Viewpoint article in the June 17 online issue of The Lancet the experts say, “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.”They point out that because there is such an emphasis on diastolic pressure, patients are not getting their systolic blood pressure adequately controlled.

They write, “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.”

My Take?

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.

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.

Nevertheless, until this advice is recommended by major groups in the U.S., my plan is to continue to concentrate on systolic and diastolic blood pressure for patients of any age.