Harvard Heart Letter

A blood pressure problem that's isolated in name only

Isolated systolic hypertension should demand your attention.

Stiff joints are an outward sign of aging. They're a pain, literally, and can slow you down or keep you from doing the things you want to do. Stiff arteries are equally problematic. They are the main culprit behind the gradual rise in blood pressure with age. You can't feel high blood pressure, but it can stop you just as surely as stiff joints can, and sometimes more permanently.

A blood pressure reading contains two numbers. The top number is the systolic pressure. It gauges the pressure in the arteries when the heart contracts and pushes a wave of blood along the arterial tree. The bottom number is the diastolic pressure. It reflects the pressure during the lull between waves, as the heart relaxes in between beats.

It takes a fair amount of pressure to push blood through miles of arteries. Too much pressure, though, is a bad thing. It injures cells lining the inside of arteries. It also makes them vulnerable to the microscopic changes that lead to atherosclerosis. In other words, high blood pressure sets the stage for cardiovascular catastrophes like heart attack and stroke.

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