Why is my top number high on my blood pressure

Isolated systolic hypertension is a type of high blood pressure. A healthcare professional may diagnose it if systolic blood pressure is more than 130 mm Hg and diastolic blood pressure is less than 90 mm Hg.

Isolated systolic hypertension is most common in older adults, but it can also affect younger adults.

It is often asymptomatic but can cause serious complications without treatment.

This article discusses what isolated systolic hypertension is, its symptoms, causes, and treatment options. It also examines whether the relevant authorities consider it a disability.

When blood circulates throughout the body, it puts pressure on the artery walls. This is known as blood pressure.

As part of a health checkup, a technician may check a person’s blood pressure. A blood pressure reading provides two numbers known as systolic, which is the upper or first number, and diastolic, which is the lower or second number.

A person has high blood pressure when the numbers rise above the normal range. Isolated systolic hypertension occurs when just the systolic number is high.

Isolated systolic high blood pressure is a cause for concern, and a person needs to address it. Over time, untreated systolic hypertension can lead to several serious complications.

A 2021 article notes that systolic hypertension occurs most often in older people. About 30% of people over the age of 60 experience this type of hypertension.

Younger adults have a significantly lower chance of experiencing systolic hypertension. About 6% of those aged 40–50 and 1.8% of those aged 18–39 are living with the condition.

However, according to research from 2016, young adults with high blood pressure or systolic hypertension have an increased risk of developing heart disease or dying.

Isolated systolic hypertension has the same general causes as regular high blood pressure.

Some potential causes and risk factors include:

• a diet containing high quantities of salt and processed foods and low levels of potassium
• smoking
• physical inactivity
• obesity
• consuming too much alcohol
• genetics
• family history of certain medical conditions, such as hypertension, diabetes, heart disease, or kidney disease

A person is also more likely to develop high blood pressure as they get older. In addition, Black people are more likely to develop high blood pressure.

Learn more about hypertension in African Americans here.

In rare cases, it may occur as a result of other conditions, such as:

• chronic kidney disease
• diabetes
• anemia
• Paget’s disease of the bone
• renal artery stenosis, which is the narrowing of the arteries that deliver blood to the kidneys
• aortic insufficiency, which is a disease that affects the heart valve
• hypothyroidism
• hyperthyroidism
• peripheral vascular disease, which restricts blood flow as a result of narrowed or blocked arteries
• arteriovenous fistula, which is when there is an abnormal connection between an artery and vein

In 2017, the American Heart Association (AHA) changed the classification for isolated systolic high blood pressure from any number over 140 millimeters of mercury (mm Hg) to any reading over 130 mm Hg.

A single high reading or isolated readings above 130 mm Hg do not necessarily mean a person should be concerned. According to the CDC, a doctor may diagnose high blood pressure if a person’s systolic blood pressure is consistently above 130 mm Hg.

However, some practices use the early standard of 140 mm Hg for systolic pressure to diagnose hypertension. In those cases, a doctor may still recommend taking steps to help reduce blood pressure, even if they cannot diagnose the condition.

Treating isolated systolic hypertension involves a combination of lifestyle changes and medical interventions.

According to the AHA, the most important steps a person can take to treat or prevent high blood pressure include:

• avoiding or limiting alcohol to no more than one drink per day for females and two per day for males
• limiting sodium intake to less than 1.5 grams per day
• exercising regularly
• measuring blood pressure regularly
• managing stress
• quitting smoking
• achieving and maintaining a moderate weight

A person may also find it beneficial to follow the DASH diet to help reduce high blood pressure.

A healthcare professional can recommend medications such as:

• diuretics
• angiotensin converting enzyme (ACE) inhibitors
• angiotensin receptor blockers
• calcium channel blockers

Within 8–10 years, 30% of those with mild to moderate high blood pressure have a higher chance of developing atherosclerosis disease, which is when plaque builds up in the arteries. Organ damage may occur in 50% of people.

Without treatment, isolated systolic hypertension may lead to:

• heart failure
• heart attack
• stroke
• aneurysm
• chronic kidney disease
• erectile dysfunction
• vision problems, such as retinopathy

Not all cases of isolated systolic hypertension will qualify for disability benefits. Like other conditions, a person would need to demonstrate that their condition impacts their ability to work.

In some cases, the authorities do not consider high blood pressure a disability, but an underlying cause could be. For example, the Social Security Administration (SSA) does not mention hypertension as a qualifying condition, but several conditions that can lead to hypertension appear in its listings as possible reasons to apply for disability benefits.

The Department of Veterans Affairs does allow a veteran with isolated systolic hypertension to apply for disability benefits through its office. However, similar to the SSA, a person needs to meet certain criteria to qualify.

A person diagnosed with isolated systolic hypertension who believes they can no longer work should speak with a doctor. A doctor can help advise the person on whether or not they may qualify for benefits.

A person is unlikely to know they have isolated systolic hypertension because it often does not cause any symptoms. A doctor may diagnose isolated systolic hypertension based on a few high blood pressure readings over the course of a few to several visits.

A person undergoing treatment for high blood pressure or who is at risk of high blood pressure should consider monitoring it at home regularly.

They should contact a doctor if their treatment methods are not working or their blood pressure starts to go up.

Isolated systolic hypertension is a form of high blood pressure. Though it is most common in older adults, it can occur in younger adults and may increase a younger person’s risk of heart disease or death. Symptoms typically do not occur.

Treatment typically involves monitoring blood pressure, medications, and lifestyle changes. A person should talk with their doctor if treatment steps do not help.

Read this article in Spanish.