High Blood Pressure: Why Is Systolic High but Diastolic Normal?

Q: High Blood Pressure: Why Is Systolic High but Diastolic Normal?

Hello： The definition of hypertension is a systolic blood pressure of 140 mmHg or higher, or a diastolic blood pressure of 90 mmHg or higher. <br>If you only have elevated systolic blood pressure, it may be related to vascular stiffness. <br>Additionally, blood pressure can be in

Hypertension issues

Hello doctor, I have had high blood pressure issues for about four years, starting when I was in high school, but I didn't pay much attention to it at that time.
Recently, I have started to take it more seriously.
Every time I go to the hospital, my blood pressure is around 140.
Today, my blood pressure was 140/79.
Could you please explain why my systolic pressure is too high while my diastolic pressure is within the normal range? Since this has been going on for several years, I wonder if it could be essential hypertension.

., 20~29 year old female. Ask Date: 2023/12/22

Dr. Lin Zhebin reply Family Medicine

Hello: The definition of hypertension is a systolic blood pressure of 140 mmHg or higher, or a diastolic blood pressure of 90 mmHg or higher.
If you only have elevated systolic blood pressure, it may be related to vascular stiffness.
Additionally, blood pressure can be influenced by factors such as activity and emotions (in a hospital setting, it can sometimes be affected by the environment or anxiety).
Therefore, it is recommended that you measure your blood pressure at home during a calm time (usually in the morning before breakfast).
If your systolic blood pressure remains 140 mmHg or higher over an extended period, it is advisable to seek medical treatment for hypertension.

Reply Date: 2023/12/22

More Info

High blood pressure, or hypertension, is a common condition that can have serious health implications if left untreated. Your observation of having a high systolic blood pressure (the top number) while your diastolic blood pressure (the bottom number) remains within a normal range is not uncommon and can be attributed to several factors.

Firstly, it's important to understand the difference between systolic and diastolic blood pressure. Systolic pressure measures the force of blood against the artery walls when the heart beats, while diastolic pressure measures the same force when the heart is at rest between beats. A reading of 140/79 mmHg indicates that your systolic pressure is elevated (140 mmHg), while your diastolic pressure is normal (79 mmHg).
This phenomenon is often referred to as "isolated systolic hypertension," which is more common in older adults but can also occur in younger individuals. Several factors can contribute to this condition:
1. Arterial Stiffness: As people age, their arteries can become stiffer and less elastic. This stiffness can lead to higher systolic pressure while diastolic pressure may remain stable or even decrease.

2. Lifestyle Factors: Diet, physical activity, and stress levels can significantly impact blood pressure. High sodium intake, lack of exercise, and high levels of stress can all contribute to elevated systolic pressure.

3. Genetics: Family history plays a crucial role in hypertension. If you have a family history of high blood pressure, you may be genetically predisposed to developing it.

4. Hormonal Factors: Conditions that affect hormone levels, such as hyperthyroidism or adrenal gland disorders, can lead to elevated systolic blood pressure.

5. Weight and Body Composition: Being overweight or obese can increase the workload on your heart and lead to higher blood pressure readings.

6. Physical Fitness: Interestingly, individuals who are physically fit may have lower diastolic pressures due to better heart efficiency, while systolic pressure can still be elevated due to other factors.

Given that you have been experiencing high blood pressure for several years, it is essential to monitor your condition closely. While isolated systolic hypertension can be less concerning than elevated diastolic pressure, it still poses risks, including an increased likelihood of heart disease, stroke, and kidney problems.

To manage your blood pressure effectively, consider the following recommendations:
- Regular Monitoring: Keep track of your blood pressure readings at home and share them with your healthcare provider. This will help in assessing trends and determining the best course of action.

- Lifestyle Modifications: Adopt a heart-healthy diet rich in fruits, vegetables, whole grains, and lean proteins. Limit your intake of sodium, saturated fats, and sugars. Regular physical activity, such as brisk walking or cycling, can also help lower blood pressure.

- Weight Management: If you are overweight, losing even a small amount of weight can significantly impact your blood pressure.

- Stress Management: Engage in relaxation techniques such as yoga, meditation, or deep breathing exercises to help manage stress levels.

- Medication: If lifestyle changes are insufficient, your doctor may prescribe antihypertensive medications to help control your blood pressure.

In conclusion, while having a high systolic pressure with a normal diastolic pressure can be concerning, it is manageable with the right lifestyle changes and medical guidance. It is crucial to maintain regular check-ups with your healthcare provider to monitor your condition and adjust your treatment plan as necessary.

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