Medical Chronicle November/December 2013 | Page 22

CARDIAC

PROF JAMES KER
Consulting Editor

Systolic
blood pressure control

About 54% of the stroke burden and
47% of ischaemic heart disease burden
worldwide is attributable to high blood
pressure. These figures give a glimpse
of the large impact that elevated blood
pressure has on mortality and morbidity. Systolic hypertension is more common than diastolic hypertension and
systolic blood pressure contributes
more of this global burden of disease
than diastolic blood pressure. The
blood pressure profiles change as people age in such a way that up to 75%
of people with high blood pressure are
above the age of 50 years and the main
cause for the elevated blood pressure
is systolic blood pressure. Above the
age of 50, blood pressure is all about
systolic pressure.
Furthermore, with increasing age,
as the systolic blood pressure rises,
the diastolic blood pressure tends to
flatten out and may even start to lower
so that the pulse pressure increases.
This condition that became recognised
as isolated systolic hypertension is
caused mainly by an increased stiffness of the arteries due to a reduction
of compliance and reduced elasticity
of the blood vessels, which includes
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