- With Mayo Clinic emeritus hypertension specialist
Sheldon G. Sheps, M.D.
read biographyclose windowBiography of
Sheldon G. Sheps, M.D.
Sheldon Sheps, M.D.
Dr. Sheldon Sheps, emeritus professor of medicine and former chair of the Division of Nephrology and Hypertension in the Department of Medicine at Mayo Clinic, has been with Mayo Clinic since 1960.
Dr. Sheps, a Winnipeg, Manitoba, native, is board certified in internal medicine and specializes in hypertension and peripheral vascular diseases. He developed a multidisciplinary approach with specially trained nurses, dietitians, technicians and educators to help form a team approach to the treatment of patients with abnormal blood pressure.
"I have always believed in involving the patient and family in their health care," Dr. Sheps says. "I have asked for their understanding of the illness and issues and for participation in decisions. The Web is a natural extension of that, and now many more people can be informed."
Dr. Sheps chaired the sixth working group, and he participated in the fourth, fifth and seventh groups that developed the then-latest guidelines for hypertension under the auspices of the National Heart, Lung, and Blood Institute (NHLBI). He helped write the latest American Heart Association (AHA) report on blood pressure measurement. He chaired an AHA group that produced an online accreditation for blood pressure measurement for health professionals.
Dr. Sheps has co-authored books, newsletters, CD-ROMs and other Mayo Clinic health information material. He joined Mayo Clinic's Web team in 1998. He was medical editor-in-chief of both editions of the "Mayo Clinic on High Blood Pressure" book; the last edition was published in 2003. He was also medical editor-in-chief of "Mayo Clinic 5 Steps to Controlling High Blood Pressure," published in 2008.
In addition, Dr. Sheps was section editor for each of the first three editions of "Hypertension Primer" for the American Heart Association.
Dr. Sheps was also chairman of the Science Base Subcommittee and the National High Blood Pressure Education Program, and he was a consultant to the Hypertension Initiative of the World Health Organization. In 1997, he was honored with the Individual Achievement Award on the 25th anniversary of the National High Blood Pressure Education Program of NHLBI. In 2009, he was honored as a Distinguished Mayo Alumnus.
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Symptoms (1)
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Causes (5)
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Complications (1)
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Treatments and drugs (7)
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Lifestyle and home remedies (11)
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Alternative medicine (2)
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Question
Isolated systolic hypertension: A health concern?
Is having a high systolic (top number) blood pressure, but a normal diastolic (bottom number) cause for concern?
Answer
from Sheldon G. Sheps, M.D.
Yes. If you have a diastolic number — the bottom number of a blood pressure measurement — less than 90 millimeters of mercury (mm Hg) and a systolic number — the top number of a blood pressure measurement — greater than 140 mm Hg, you have a common type of high blood pressure called isolated systolic hypertension. Isolated systolic hypertension can be caused by underlying conditions such as a leaky heart valve or an overactive thyroid (hyperthyroidism).
For years, doctors focused primarily on diastolic blood pressure. The theory was that the body could tolerate occasional increases in systolic blood pressure, but consistently high diastolic pressure could lead to health problems. However, doctors now know that high systolic pressure is as important as high diastolic pressure — and even more important in people older than age 50.
The recommended goal for systolic pressure is less than 140 mm Hg. For people who are 80 or older, the target systolic pressure ranges from 140 to 145 mmHg. In people with isolated systolic hypertension, treatment may lower diastolic pressure too much, potentially increasing the risk of a heart attack or stroke. So if you have isolated systolic hypertension, your doctor may recommend that your diastolic pressure not be reduced to less than 70 mm Hg in trying to reach your target systolic pressure.
Isolated systolic hypertension, when combined with other risk factors such as poor diet and lack of exercise, can lead to serious health problems, such as:
- Stroke
- Heart disease
- Chronic kidney disease
- Dementia
White-coat hypertension: When blood pressure rises at the doctor's office
- Kaplan NM, et al. Treatment of hypertension in the elderly, particularly isolated systolic hypertension. http://www.uptodate.com/home/index.html. Accessed March 17, 2011.
- Stokes GS. Treatment of isolated systolic hypertension. Current Hypertension Reports. 2006;8:377.
- McEniery CM, et al. Aortic calcification is associated with aortic stiffness and isolated systolic hypertension in healthy individuals. Hypertension. 2009;53:524.
- Aronow WS, et al. ACCF/AHA 2011 expert consensus document on hypertension in the elderly. Journal of the American College of Cardiology. 2011;57:2037.
- Health care guideline: Hypertension diagnosis and treatment. Bloomington, Minn.: Institute for Clinical Systems Improvement. http://www.icsi.org/hypertension_4/hypertension_diagnosis_and_treatment_4.html. Accessed Jan. 25, 2012.
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