From the Guidelines
High systolic blood pressure is primarily caused by factors such as aging, which leads to stiffening of the arteries, kidney disease, and atherosclerosis, as well as lifestyle factors including obesity, high sodium intake, and physical inactivity, as noted in the 2020 U.S. Department of Veterans Affairs/U.S. Department of Defense clinical practice guideline 1.
Causes of High Systolic Blood Pressure
The causes of high systolic blood pressure can be multifaceted, including:
- Aging, which leads to stiffening of the arteries
- Kidney disease, affecting fluid balance
- Atherosclerosis, where plaque builds up in the arteries
- Obesity
- High sodium intake
- Excessive alcohol consumption
- Physical inactivity
- Stress
- Certain medications like NSAIDs, decongestants, and some antidepressants
- Medical conditions such as sleep apnea, thyroid disorders, and adrenal gland tumors
- Genetics, as high blood pressure often runs in families
Importance of Monitoring and Treatment
It is crucial to monitor blood pressure regularly and manage high systolic blood pressure to reduce the risk of heart disease, stroke, and kidney damage, as emphasized in the 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults 1.
Lifestyle Modifications and Treatment
Treatment typically involves lifestyle changes such as:
- Reducing salt intake
- Regular exercise
- Weight management Along with medications if necessary, as recommended in the 2015 American Heart Association scientific statement on congenital heart disease in the older adult 1.
From the Research
Reasons for High Systolic Blood Pressure
- High systolic blood pressure can be caused by various factors, including lifestyle and genetic predisposition 2, 3, 4, 5
- Studies have shown that lifestyle modifications, such as weight loss, healthy dietary patterns, physical activity, and moderation or elimination of alcohol consumption, can help lower systolic blood pressure 2, 3, 4, 5
- Additionally, stress management techniques, such as relaxation response training, have been found to be effective in reducing systolic blood pressure in some individuals 6
Lifestyle Modifications for Lowering Systolic Blood Pressure
- Regular physical exercise can help reduce systolic blood pressure by improving vascular health and reducing sympathetic overactivation 3, 5
- Healthy dietary patterns, including low sodium and high potassium intake, can also help lower systolic blood pressure 2, 3, 5
- Weight management and body mass index (BMI) reduction can also contribute to lowering systolic blood pressure 3, 4, 5
- Stress management and adequate sleep patterns can also play a role in reducing systolic blood pressure 5, 6
Treatment and Management of High Systolic Blood Pressure
- First-line therapy for hypertension includes lifestyle modification, and when necessary, medication such as thiazide or thiazide-like diuretics, angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, and calcium channel blockers 2
- In cases of resistant hypertension, lifestyle modifications, including aerobic exercise, weight loss, and dietary modification, can be effective in reducing blood pressure 4
- Supervised medication elimination can also be considered for individuals who have achieved significant reductions in systolic blood pressure through lifestyle modifications or stress management techniques 6