Isolated systolic hypertension

 The so-called simple systolic hypertension, as the name suggests, refers to a person's diastolic blood pressure is not high, only systolic blood pressure exceeds the normal range. In March 1993, the World Health Organization re defined the standard of systolic hypertension above 21.3kpa (160mmhg) and diastolic blood pressure below 12.0kpa (90mmHg). If the systolic blood pressure is between 18.7kpa and 21.3kpa (140-160mmhg), it is called critical isolated systolic hypertension. At present, this diagnostic standard is widely used, but some diseases with increased output, such as aortic insufficiency, patent ductus arteriosus, systemic arteriovenous fistula, hyperthyroidism, severe anemia, etc., often appear simple systolic hypertension, which is not included in the scope of simple systolic hypertension. Because simple systolic hypertension occurs more in the elderly over 60 years old, so it is also called senile simple systolic hypertension, referred to as senile systolic hypertension, a small part occurs in young people with high dynamic circulation.

The incidence rate of these patients is very high. According to the sampling survey of hypertension in 30 provinces, municipalities and autonomous regions in 1993, more than 950 thousand people were investigated. The prevalence of isolated systolic hypertension was 1.25%, that is to say, 15 million of the patients with isolated systolic hypertension in the whole country, 60% of whom were elderly, about 13000000, accounting for 86.6%.

Many people don't know whether simple systolic hypertension needs treatment or not, and even mistakenly believe that high systolic blood pressure is a natural phenomenon, especially in the elderly. Is this really the case? Foreign scholars have followed up 5727 people for 20 years and found that the relationship between coronary heart disease and systolic blood pressure is significantly higher than that of diastolic blood pressure, and the relationship between stroke, left ventricular hypertrophy, congestive heart failure and systolic blood pressure is more closely than that of diastolic blood pressure. Fuwai Hospital in Beijing reported 117 cases of isolated systolic hypertension in the elderly, including 41.9% of them, 32.5% of heart failure, 28.2% of heart failure, and 57.3% of renal insufficiency. The incidence rate of hypertension was higher than that of other types of hypertension. There are also some reports that several complications of elderly hypertension, the most common in patients with systolic hypertension, especially prone to ischemic stroke. It can be seen that simple systolic hypertension must not be taken lightly.

A recent international study also pointed out that the treatment of elderly patients with simple hypertension is safe and effective, which can reduce cerebrovascular disease by 36% and cardiovascular disease by 32%. Therefore, it is suggested that simple systolic hypertension should be treated in time.

The treatment of simple systolic hypertension includes non drug treatment and drug treatment. Non drug treatment refers to life intervention measures, including regulating the law of life, reducing emotional stimulation, reducing excessive weight, limiting excessive nutrition, insisting on sports, limiting salt, quitting smoking, avoiding drinking, etc., which is an indispensable basic treatment for any patient with hypertension. The principle of drug therapy is to emphasize individualized treatment, pay attention to blood pressure fluctuation, target organ damage, complications and other risk factors. First, choose a single antihypertensive drug, start from a small dose, do not sharply reduce blood pressure, especially for the elderly, should pay special attention to, under the guidance of doctors, according to blood pressure monitoring, timely adjust the medication and dosage.