Isolated systolic hypertension in 14 communities

Area of Science:

• Cardiovascular epidemiology
• Public health
• Hypertension research

Background:

• Isolated systolic hypertension (ISH) is defined as systolic blood pressure (SBP) ≥160 mmHg and diastolic blood pressure (DBP) <90 mmHg.
• Previous studies have indicated varying prevalence and risk associated with ISH.

Purpose of the Study:

• To determine the prevalence of ISH in a large, diverse US population.
• To assess the association between ISH and long-term all-cause mortality.

Main Methods:

• Screening of 158,906 individuals for blood pressure in 1972-1973.
• Follow-up mortality data for 8 years on a subsample of 5,032 individuals with DBP <90 mmHg.
• Statistical analysis including life table methods and multiple logistic regression.

Main Results:

• The prevalence of ISH was 2.4% in the overall screened population, higher in older adults (6.8% in 60-69 years), Black individuals, and women.
• Among individuals not on antihypertensive medication with DBP <90 mmHg, those with SBP ≥160 mmHg had an 8-year mortality rate of 17.6% compared to 7.7% for SBP >160 mmHg.
• Each 1 mmHg increase in SBP was associated with a 1% increase in 8-year mortality (p<0.05).

Conclusions:

• Isolated systolic hypertension is a prevalent condition in the US adult population.
• ISH is a significant independent risk factor for increased all-cause mortality.
• These findings underscore the importance of identifying and managing ISH for public health.