Is the Cardiovascular Risk Increased in Patients with Isolated Systolic Hypertension and Anemia?

Area of Science:

• Cardiology
• Geriatrics
• Internal Medicine

Background:

• Isolated systolic hypertension (ISH) is a highly prevalent condition, especially among the elderly.
• Anemia is also a common non-communicable disease with significant public health implications.
• The co-existence and implications of anemia in patients with ISH remain under-recognized.

Purpose of the Study:

• To investigate the relationship between anemia and diastolic blood pressure (dBP).
• To determine the association between ISH and anemia.
• To assess the cardiovascular risk in ISH patients with co-existing anemia and its recognition in hypertension guidelines.

Main Methods:

• Literature search conducted across multiple databases (SCOPUS, Springer Verlag, Elsevier, PubMed, Google Scholar).
• Search strategy included terms for 'isolated systolic hypertension' and 'anemia', excluding guidelines.
• A separate search focused on arterial hypertension (HTN) guidelines to identify mentions of ISH, anemia, and their relationship.

Main Results:

• Anemia is frequently associated with decreased diastolic blood pressure (dBP) due to various pathophysiological mechanisms.
• Both ISH and anemia are independently associated with low dBP.
• Anemia and ISH are significant public health concerns due to their high prevalence, particularly in the elderly population.

Conclusions:

• Anemia in the context of ISH represents a significant, clinically relevant, and previously underappreciated problem.
• Patients with ISH and concurrent anemia face an elevated cardiovascular risk.
• Current hypertension (HTN) guidelines do not adequately recognize the significance of anemia in ISH, partly due to conciseness requirements.