American Journal of Epidemiology Vol. 121, No. 3: 362-370
Copyright © 1985 by The Johns Hopkins University School of Hygiene and Public Health
research-article |
ISOLATED SYSTOLIC HYPERTENSION IN 14 COMMUNITIES1
2U. of Hawaii Schools of Public Health and Medicine Honolulu, HI 96822
3U. of California School of Medicine Davis, CA
4U. of Maryland School of Medicine Baltimore, MD
5HDFP Coordinating Center Houston, TX
6Channing Laboratory Boston, MA
7U. of Alabama Birmingham, AL
8National Heart, Lung and Blood Institute (NHLBI) Bethesda, MD
9Mount Sinai Hoapital Clinical Studies Dept., Minneapolis MN
Send reprint requests to: Scientific Project Officer, HDFP, DHVD, NHLBI, Rm. 6A-14, Federal Bldg., 7550 Wisconsin Ave., Bethesda, MD 20205
In the Hypertension Detection and Follow-up Program, 158,906 individuals from 14 communities around the United States had their blood pressure measured in their homes in 1972–1973. Of the total population screened, 2.4% had isolated systolic hypertension (systolic blood pressure 
160 mmHg and diastolic blood pressure <90 mmHg). Isolated systolic hypertension was present for 0.5% of those aged 30–39 years and 6.8% among those aged 80–89 years. The prevalence in blacks and women was greater than the prevalencee in both whites and men. The prevalence among those taking antihypertensive medications at the time of screening was 6.1%, and 1.9% among those not on antihypertensive medicatians. From the individuals with "normal" diastolic blood pressure on the single home measurement (<90 mmHg), a random sample of 5,032 individuals were followed for mortality for eight years. Prevalence of isolated systolic hypertension was similar in this sample to that in the total. Among those not on antihypertensive medications, 8-year life table all-cause mortality rates adjusted for age, race, and sex were 17.6% for those with systalic blood pressure 160 mmHg and 7.7% for those with systalic blood pressure>160 mmHg. Among this population, all of whom had a diastolic blood pressure<90 mmHg, a muttiple 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 eight years of follow-up (p 
0.05). Isolated systolic hypertension is both relatively common and a significant risk factor for subsequent mortality.
aged; blood pressure; hypertension; mortality; prospective studies
1From the Hypertension Detection and Follow-up Program (HDFP).
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