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  Vol. 152 No. 10, OCTOBER 1992 TABLE OF CONTENTS
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The Relative Importance of Focusing on Elevations of Systolic vs Diastolic Blood Pressure

A Definitive Answer at Last

William B. Applegate, MD

Arch Intern Med. 1992;152(10):1969-1971.

Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

Since the invention of indirect auscultatory sphygmomanometry at the turn of the century, physicians have tended to focus more on treating elevations of diastolic blood pressure (DBP) than elevations of systolic blood pressure (SBP). As described by Rutan et al,1 the primary focus on DBP resulted from theoretical concerns that the level of DBP was more related to end organ damage. Also, as mentioned by Mann2 in the review article in this edition, the original Veterans Affairs Cooperative Study, the first to prove benefit in treating high blood pressure, focused on DBP. The fact that SBP rises on average throughout the life span in industrialized societies gave impetus to the notion that elevation of SBP was an aging-related phenomenon attributable to decreased compliance of the major arteries. A common clinical dictum for years was that a normal SBP for older persons was "100 plus the person's age." Therefore, . . . [Full Text PDF of this Article]


Author Affiliations

University of Tennessee Medical Group 66 N Pauline, Suite 232 Memphis, TN 38105



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