High Systolic Blood Pressure: Causes And Treatments Explained

Blood pressure is defined as the pressure exerted on the walls of the arteries as the heart pumps blood. High blood pressure occurs when the heart exerts more pressure than normal on the arteries when pumping blood. This disease is also known as hypertension.

According to the Centers for Disease Control and Prevention (CDC), nearly half or approximately 116 million adults in the US live with hypertension

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Understanding blood pressure readings

Blood pressure is measured in millimeters of mercury (mm Hg), and the readings are given as two numbers. The top number is the systolic blood pressure, and it refers to the amount of pressure in your arteries when the heart beats. The bottom number is the measure of the force of blood in your arteries when your heart relaxes between beats and is known as the diastolic blood pressure.

The systolic blood pressure is the higher of the two, and a normal adult's blood pressure reading should be less than 120/80mm Hg.

There are different types of high blood pressure depending on the rise in one or both numbers.

High systolic blood pressure explained

High systolic blood pressure, also known as isolated systolic hypertension (ISH), occurs when your systolic blood pressure is 140mm Hg or higher and the diastolic pressure is less than 90mm Hg. It is the most common type of hypertension among people of 65 years and above and puts younger people at risk of heart attack or stroke.² ³

Causes

Blood pressure, especially ISH, is known to increase with age.² As you age, your blood vessels naturally become rigid, decreasing their ability to accommodate the rush of blood and thus putting you at a higher risk of getting high systolic blood pressure. Because of this, there might be no identifiable cause of blood pressure.

However, other underlying medical conditions can stimulate the development of ISH, which include:

Diabetes

Diabetes occurs when either your body does not produce enough insulin (type 1 diabetes) or when your body uses insulin poorly (type 2 diabetes). Over time, high sugar levels in the blood damage the small blood vessels in the body, causing their walls to stiffen, thus increasing pressure as the heart pumps blood.

Hyperthyroidism

Hyperthyroidism refers to the overproduction of the thyroid hormone that acts to decrease the blood vessels' resistance, increasing your heartbeat. This condition might lead to Isolated systolic hypertension.

Anemia

Anemia occurs when your red blood cells default or when there aren't enough of them to carry blood to your tissues. When you have anemia, your heart tries to pump blood harder to supply sufficient oxygen, which might damage the blood vessels and, in turn, cause ISH.

Other conditions that might lead to high systolic blood pressure include:

  • Disorder of the adrenal gland

  • Preeclampsia 

  • Heart valve problems

  • Obstructive sleep apnea

  • Medicines such as diet pills, birth control pills, some antipsychotics, some cold medicines, corticosteroids, migraine medicines, and some medicines used to treat cancer

Signs and symptoms

High blood pressure is famous as the "silent killer" as it sometimes doesn't exhibit any signs and symptoms. Most people often find out they have high systolic blood pressure after a visit to their physician, sometimes after it has caused detrimental effects to the body. Regular checkups are therefore essential to detect such conditions at an early stage.

Risk factors

Like any other type of hypertension, the following factors can put you at a higher risk of developing ISH.

Obesity

If you are obese or overweight, your body must pump blood and oxygen harder, which could cause stress to your heart and blood vessels over time, potentially leading to ISH.

Alcohol intake

Increased intake of alcohol is known to raise blood pressure steadily.⁴ Females taking more than one drink a day and men taking more than two drinks a day expose themselves to the potential of high systolic blood pressure.

High salt consumption

Sodium in salt is essential for the body to function well but can be detrimental when used in excess. Consumption of over 2,300mg for healthy adults can lead to high systolic blood pressure.⁵ Adults with high blood pressure should limit their intake to 1,500mg to prevent further complications like heart failure.

Genetics and family history

If you have a family member with high systolic blood pressure or ISH, you are at risk of developing it yourself. This is because the ISH traits can be passed down from one generation to another. Additionally, people of the same family are likely to share a common environment and other potential factors like an unhealthy lifestyle that can increase their risk.

Race

African-Americans in the US are at a higher risk of developing high systolic blood pressure than other races, primarily because of genetics and other environmental factors.⁶

Smoking

High tobacco and nicotine intake in the body can make your blood vessels narrow and increase your heartbeat, which can, in turn, increase blood pressure.⁷

Complications

When you leave your high blood pressure uncontrolled, it can damage your arteries, affecting other body parts and potentially increasing the risk of the conditions below:

  • Heart attack

  • Kidney disease

  • Heart failure

  • Stroke

  • Dementia

  • Aneurysm

  • Vision loss

Treatment

High systolic blood pressure can be treated either through medication, a change of lifestyle, or both. The aim is often to reduce the systolic blood pressure to below 120mm Hg without reducing the diastolic pressure too much. Therefore, the treatment must be balanced as a lower-than-usual diastolic pressure can lead to heart damage.

According to the American Journal of Medicine, the following treatments effectively reduce the risk of cardiovascular diseases and stroke in elderly adults with ISH.⁸

Calcium channel blockers

Calcium channel blockers reduce calcium flux in the cells by dilating arteries, effectively lowering blood pressure, especially when combined with other drugs. They are known to work across all patients regardless of age, race, sex, and dietary sodium intake.

Angiotensin-converting enzyme inhibitors

Angiotensin-converting enzyme (ACE) works by preventing the production of angiotensin II — a substance that narrows blood vessels — thus helping the veins and arteries to relax and lower blood pressure. Examples of ACE inhibitors include captopril, benazepril (Lotensin), lisinopril (Prinivil, Zestril), enalapril (Vasotec), moexipril, etc.

Diuretics

Also known as the "water pills,” diuretics work in the kidney by getting rid of unneeded salts and water in the urine. When water is removed from your blood, the amount of fluid flowing through the artery also reduces, reducing the blood pressure in your body. In ISH treatment, your doctor can either issue you with loop, thiazide, or potassium-sparing diuretics.

Vasodilators

These are medicines used to prevent blood vessels from constriction, thus allowing a greater flow of blood to various organs in the body. They can be administered either orally, sublingually (under the tongue), or via IV.

Alpha-adrenergic blockers

Alpha-blockers are another known treatment for high systolic blood pressure. They act by inhibiting a hormone called norepinephrine from tightening the muscles in the walls of veins and arteries, thus improving blood flow and lowering blood pressure.

Combination medicines

A combination of antihypertensive agents has been seen to produce greater blood pressure reduction than when using monotherapies. Your doctor can recommend the combination of a renin-angiotensin with a calcium antagonist to effectively manage your high systolic blood pressure.

Lifestyle changes as a treatment

Besides medication, you may also need some lifestyle changes, which include:

Losing weight

Being overweight or obese can contribute greatly to the development of ISH. As such, losing weight is essential in eliminating blood pressure as it will help in reducing both diastolic and systolic pressure. For every 20 pounds you lose, your systolic pressure can drop 5–20 points.

Eating healthy

Eating a healthy meal that comprises low-fat foods, vegetables and fruits can lower your systolic pressure by 8–14 points. Consider trying the dietary approach to stop hypertension (DASH) eating as a guide to stop hypertension. This eating plan includes the following:

  • 4–5 servings of vegetables per day

  • 6–7 servings of grains daily, preferably whole grains or oats

  • Less than two servings of poultry, lean meat, or seafood daily

  • 4–5 fruit servings per day (Fruits and vegetables rich in potassium like tomatoes, dates, bananas, avocados, cantaloupe, oranges, and raisins are an added advantage. Fruits rich in nitrates like beets are effective as well.)

  • 2–3 servings of fat-free dairy (or low-fat)

  • 3–4 servings of nuts, beans, and seeds per week

  • At least five servings of natural yogurt

  • Less than two servings of poultry, lean meat, or seafood daily

  • 2–3 daily servings of fats and oils

Reducing the intake of alcohol

To keep your systolic blood pressure normal, you will have to cut down on your drinking. After a meal, a glass of red wine is okay, but taking over the recommended amount (one drink per day for women and two drinks per day for men) may be hazardous.

Exercising

Exercising is an instrumental tool for managing and preventing high systolic blood pressure. Engaging in moderate-intensity exercise for at least 30 minutes three times a week or resistance exercise at least twice or thrice a week can help keep the body active.⁹ This will help decrease blood pressure and help control weight and stress levels.

Managing stress

Stress is attributed to sudden surges in systolic blood pressure. Though it might not cause long-term effects, it is advisable to keep stress levels low. Some ways of lowering stress levels include exercising regularly, avoiding stress triggers, and cutting down on nicotine products. You can also discuss stress-reducing medication with your physician if the stress escalates.

Quitting smoking

Smoking is known to be harmful to the body. It is, therefore, advisable to quit smoking as that will help you manage your blood pressure and avoid other detrimental effects that come with smoking, including cancers.

Prevention

The damage caused by blood pressure in your internal organs does not show any symptoms until great damage has been done. Therefore, you must take charge of your health and help prevent this "silent killer" from making its way to your body.

The best way to prevent high systolic blood pressure would be to practice all the lifestyle changes mentioned above. Additionally, you should make regular visits to your doctor to monitor any preexisting health conditions and get them under control. Monitoring your blood pressure at home will also help you track your progress between your routine checkups.

Frequently asked questions

Is it normal for blood pressure to be higher in the afternoon?

Yes. Your blood pressure starts to rise a few hours before you wake up and increases throughout the day. It reaches its peak at midday and begins to drop late afternoon or evening. Therefore, your blood pressure may be higher in the afternoon than in the morning and lowest at night as you sleep, when you are most relaxed.

If you are experiencing high blood pressure during the night or in the early mornings, it could mean that you have diabetes, kidney disease, thyroid disease, or a nervous system disorder, and you should see a doctor.

How can I lower my afternoon blood pressure?

If you want to lower your afternoon blood pressure, you might benefit from a midday nap. It helps regulate your blood pressure and might decrease the number of antihypertensive medications required. For each hour you rest, your systolic blood pressure drops at an average of 3mm Hg.¹⁰ You should also consider reducing your caffeine intake, making your blood pressure rise. You may need blood pressure-lowering medication later in the morning or early afternoon to prevent this blood pressure spike. 

The lowdown

High systolic blood pressure is attributed to older age and other underlying conditions like diabetes, obesity, artery stiffness, heart valve problems, and hyperthyroidism. Though medication is issued to treat high systolic blood pressure, the condition cannot be fully cured. However, you can live a long productive life with an improved lifestyle like eating healthy, exercising, quitting alcohol, and quitting smoking. It is also essential that you follow your prescription as administered by your doctor.

  1. Facts about hypertension | Centers for Disease Control and Prevention

  2. High blood pressure and older adults | National Institute on Aging

  3. High systolic blood pressure increases heart risk in young adults | CardioSmart – American College of Cardiology

  4. Facts about aging and alcohol | National Institute on Aging

  5. Sodium in diet | MedlinePlus Medical Encyclopedia

  6. Genetics of hypertension in African Americans and others of African descent (2019)

  7. Hypertension | World Health Organization

  8. Isolated systolic hypertension: An update after SPRINT (2016)

  9. Exercise and hypertension (2020)

  10. A nap a day keeps high blood pressure at bay | CardioSmart – American College of Cardiology

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