Document Detail


What is the most important component of blood pressure: systolic, diastolic or pulse pressure?
MedLine Citation:
PMID:  12698068     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE OF REVIEW: Diastolic blood pressure has traditionally been considered the most important component of blood pressure and the primary target of antihypertensive therapy. However, over 30 years ago important epidemiological studies pointed out the importance of systolic blood pressure, and research during the 1990s has strengthened this view. Unlike diastolic blood pressure, systolic blood pressure increases progressively with age, and in the ageing societies elevated systolic pressure is the most common form of hypertension. The characteristic changes of systolic and diastolic blood pressure with age lead to increases in pulse pressure (systolic minus diastolic), which has emerged as a new, potentially independent risk factor. In this review we compare the relative importance of various blood pressure components. RECENT FINDINGS: Generally, in studies in which readings of systolic and diastolic blood pressure have been compared, systolic blood pressure has been a better predictor of risk. Moreover, isolated systolic hypertension predicts risk better than isolated diastolic hypertension, and the treatment of both isolated systolic hypertension and combined hypertension has reduced cardiovascular events. There are no treatment studies of isolated diastolic hypertension. Pulse pressure reflects stiffening of large arteries and is associated with several cardiovascular risk factors. Pulse pressure also predicts events in epidemiologic studies, but elucidation of an independent role is hampered by the close correlation between pulse pressure and systolic blood pressure. SUMMARY: Epidemiological and treatment studies suggest that systolic blood pressure should be the primary target of antihypertensive therapy, although consideration of systolic and diastolic pressure together improves risk prediction. The greatest practical concern at the moment is the undertreatment of hypertension, especially systolic, and total cardiovascular risk.
Authors:
Timo E Strandberg; Kaisu Pitkala
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Current opinion in nephrology and hypertension     Volume:  12     ISSN:  1062-4821     ISO Abbreviation:  Curr. Opin. Nephrol. Hypertens.     Publication Date:  2003 May 
Date Detail:
Created Date:  2003-04-16     Completed Date:  2004-01-26     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9303753     Medline TA:  Curr Opin Nephrol Hypertens     Country:  England    
Other Details:
Languages:  eng     Pagination:  293-7     Citation Subset:  IM    
Affiliation:
Department of Medicine, Geriatric Clinic, University of Helsinki, Helsinki, Finland. timo.strandberg@hus.fi
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MeSH Terms
Descriptor/Qualifier:
Antihypertensive Agents / therapeutic use
Blood Pressure / drug effects,  physiology*
Cardiovascular Diseases / etiology,  physiopathology
Diastole / drug effects,  physiology
Humans
Hypertension / complications,  drug therapy,  physiopathology
Risk Factors
Systole / drug effects,  physiology
United States
Chemical
Reg. No./Substance:
0/Antihypertensive Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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