Where should we focus: systolic blood pressure versus diastolic blood pressure?
Physicians tend to react more to diastolic blood pressure higher than 90 mm Hg than systolic blood pressure higher than 140 mm Hg, which results in suboptimal control rate of isolated systolic hypertension.26 This is partly because the historical emphasis had been on diastolic blood pressure. Control of systolic blood pressure is also harder to achieve than that of diastolic blood pressure.27 However, isolated systolic hypertension comprises the majority of untreated and undertreated hypertension in adults over age 50.31 Compared to diastolic blood pressure, systolic blood pressure is more easily and accurately measured and is a better predictor of CV events.32 From the public health perspective, focusing on a single number may reduce confusion and improve the control rate.33 Does low diastolic blood pressure pose any harm in treating isolated systolic hypertension? Low diastolic blood pressure has been associated with increased mortality (“J-curved relationship”). This is often the re
