ISOLATED SYSTOLIC HYPERTENSION IN 14 COMMUNITIES

In the Hypertension Detection and Follow-up Program, 158,906 individuals from 14 communities around the USA had their blood pressure measured in their homes in 1972-1973. Of the total population screened, 2.4% has isolated systolic hypertension (systolic blood pressure .gtoreq. 160 mmHg and diastolic blood pressure < 90 mmHg). Isolated systolic hypertension was presentfor 0.5%of those aged 30-39 yr and 6.8% among those aged 60-69 yr. The prevalence in blacks and women was greater than the prevalences in both whites and men. The prevalence among those taking antihypertensive medications at thetime of screening was 6.1%, and 1.9% among those not on antihypertensive medications. From the individuals with "normal" diastolic blood pressure on the single home measurement (< 90 mmHg), a random sample of 5032 individuals was followed for mortality for 8 yr. Prevalence of isolated systolic hypertension was similar in this sample to that in the total. Among those not on antihypertensive medications, 8-yr life table all-cause mortality rates adjusted for age, race, and sex were 17.6% for those with systolic blood pressure .gtoreq. 160 mmHg and 7.7% for those with systolic blood pressure > 160 mmHg. Among this population, all of whom had a diastolic blood pressure < 90 mmHg, a multiple logistic analysis adjusting for baseline treatment, status, age, race, sex, education, smoking, weight, pulse, physical activity, and systolic blood pressure, revealed that each millimeter increase in systolic blood pressure was associated with approximately a 1% increase in mortality over the 8 yr of follow-up (P < 0.05). Isolated systolic hypertension is both relatively common and a significant risk factor for subsequent mortality.