Systolic Blood Pressure – Everything You Need to Know

systolic blood pressure

The one number that most people concentrate on when looking at their blood pressure readings is the top number. The top number is your systolic blood pressure. At the medical center, I ask many people about their blood pressure reading. Most of them remember their systolic blood pressure number but hardly anyone can recall the bottom number.

What is systolic blood pressure? Systolic blood pressure is the top number of your blood pressure reading. Systolic blood pressure indicates how much pressure your blood is exerting against your artery walls when the heart beats pumping blood out. Therefore, a blood pressure reading of 120/80, 120 is the systolic blood pressure. 

Both blood pressure numbers are important and either number can be used as a diagnosis for high blood pressure. But for people age 50 or older, doctors tend to monitor the systolic blood pressure number more closely. In addition, isolated systolic hypertension is the most common form of high blood pressure (resource).

It’s more typically for the elderly to have high systolic blood pressure but there are times when younger adults get it also. This post will dive into the risk factors, treatments and the consequences if you don’t keep your systolic blood pressure under control.

The Systolic Blood Pressure Numbers In Each category

Systolic Normal Blood Pressure

A systolic blood pressure of less than 120 mm Hg and a diastolic number less than 80 indicates normal blood pressure (resource). If your blood pressure readings are consistently in this range, you should continue following a heart healthy diet and engage in regular physical activity. Continue to monitor your blood pressure readings and go for regular physicals.

Systolic Elevated Blood Pressure

Elevated blood pressure is when your systolic blood pressure is consistently between 120-129 mm Hg and your diastolic number is less than 80 (resource). If your systolic blood pressure is elevated you are more likely to develop high blood pressure unless you take action now to manage the condition. A doctor would recommend making lifestyle changes to lower your blood pressure into the normal range.

Systolic High Blood Pressure Stage 1

A systolic blood pressure consistently between 130-139 mm Hg would put you into the high blood pressure stage 1 range, regardless of your diastolic number (resource). Doctors typically recommend lifestyle changes and may consider prescribing medication based on your cardiovascular disease risk.

Systolic High Blood Pressure Stage 2

A systolic blood pressure reading consistently 140 mm Hg or higher will place you into the high blood pressure stage 2 range regardless of your diastolic number (resource). In this range doctors are likely to recommend lifestyle changes and medication.

Systolic Hypertensive Crisis

If your systolic number is higher than 180 then you are in hypertensive crisis. Hypertensive crisis is very serious, and you’re going to call a doctor or go to the hospital. If you take your blood pressure and either number is 180/120 or greater, wait about 5 minutes and take it again. If the 2nd reading is just as high and you are NOT experiencing any of the following symptoms, then contact your doctor and be guided by them (resource):

  • Chest pain
  • Shortness of breath
  • Back pain
  • Numbness/weakness
  • Change in vision
  • Difficulty breathing

If your numbers indicate a hypertensive crisis and you are experiencing one of the above symptoms you must go to a hospital. Please don’t wait for your numbers to go back down, call 911. You’re always better safe than sorry. The consequences of a hypertensive crisis can be severe or fatal. I wrote a detailed post in this same website about hypertensive crisis. You can check it out by clicking here.

systolic blood pressure

Isolated Systolic Hypertension

This is when your systolic blood pressure number is high and your diastolic number is low or normal. Isolated systolic hypertension is when your systolic blood pressure is 130 mm Hg or higher and your diastolic number is less than 80 mm Hg. This reading would place your blood pressure into the High Blood Pressure Stage 1 category. If your systolic blood pressure is 140 or higher with a diastolic number less than 80, this places your isolated systolic hypertension into the category of High Blood Pressure Stage 2 (resource).

Isolated Systolic Hypertension Causes

Isolated Systolic Hypertension In The Elderly

Systolic blood pressure rises steadily with age. This is due to the increasing stiffness of large arteries, long-term plaque buildup and an increased incidence of cardiovascular disease. According to a recent study (study), persons who reached age 65 had a 90% lifetime risk of developing high blood pressure, particularly isolated systolic hypertension, if they lived another 20 to 25 years.

Isolated Systolic Hypertension – Other Causes

In addition to aging, plaque and increased stiffness of arteries isolated systolic hypertension can be caused by the following health problems (resource):

  • Anemia: The heart works harder to deliver sufficient oxygen to the organs. This can cause damage to the blood vessels.
  • Hyperthyroidism: High blood pressure can result when the thyroid produces too much thyroid hormone. In addition, if the glands secrete too much parathyroid hormone, the amount of calcium in your blood rises, which triggers a sudden rise in blood pressure.
  • Kidney Disease: Improperly working kidneys can cause fluid retention which causes an increase in blood pressure.
  • Diabetes: Most people with diabetes will eventually have high blood pressure. Diabetes damages the arteries and makes them targets for hardening which increases the risk of high systolic blood pressure.
  • Heart valve problems: Valves that are not working properly make the heart work harder and stress the blood vessels.

Isolated Systolic Hypertension In Younger Adults

The elderly are not the only ones who can get isolated systolic hypertension. Younger people get it also but many times they slip through the cracks and don’t get the proper diagnosis. This can happen for several reasons including:

  • High systolic blood pressure in the young is often considered an anomaly and that is will go away.
  • Younger people often have worse diets that consist of fast foods and high sodium.
  • Athletes in school often take Steroids to increase their athletic performance and build up strength and muscle.
  • Some risk factors affect all ages including your adults.
  • Younger people often skip regular physicals.

In addition, a study (study) of isolated systolic hypertension in young adults found the following:

  • Young people with isolated systolic hypertension are at risk of future hardening of the arteries.
  • Increased risk of stroke and damage to the kidneys and brain.
  • Younger people with this condition may have an abnormally stiff aorta.

Isolated Systolic Hypertension During Pregnancy

High blood pressure, including isolated systolic hypertension poses various risks during pregnancy including:

  • Placental abruption: This is when the placenta separates from the inner wall of the uterus before delivery.
  • Decreased blood flow to the placenta: This can lead to low birth weight or premature birth.
  • Premature delivery: To prevent potentially life threatening complications sometimes an early delivery is needed.
  • Intrauterine growth restriction: high blood pressure might result in decreased or slowed growth of the baby.
  • Future cardiovascular disease: Having preeclampsia can increase your risk of future heart and blood vessel disease.

In 2007, a study (study) of 3,470 pregnant participants showed that 26% had isolated systolic hypertension. They also found a first delivery at an earlier age increased the risk of isolated systolic hypertension.

systolic blood pressure

Consequences Of High Systolic Blood Pressure

It’s critical to monitor and treat your blood pressure whether you are in your 50’s or younger. It’s possible that high systolic blood pressure can cause severe health issues including the following (resource):

  • Heart attack
  • Stroke
  • Vision loss
  • Chronic kidney disease
  • Heart disease
  • Stroke

In addition, for people aged from 40 to 89, for every 20 mm Hg increase in systolic blood pressure the risk of death from ischemic heart disease and stroke doubles. Ischemic heart disease, also called coronary heart disease, is caused when the narrowed arteries in the heart receive less blood and oxygen which can lead to a heart attack.

High Systolic Blood Pressure Prevention and Treatments

As noted earlier, if you have high blood pressure the doctor will recommend lifestyle style changes and may recommend medications. The following are some of the common medications used for high blood pressure, including systolic blood pressure (resource).


  • Diuretics: They help the body get rid of excess fluid and sodium to help control blood pressure.
  • Beta-blockers: Help reduce the heart rate and the heart’s output of blood which lowers blood pressure.
  • Ace inhibitors: They help the body produce less angiotensin, which helps the blood vessels open up lowering blood pressure.
  • Calcium Channel Blockers: They relax and open up narrowed blood vessels, reduce heart rate and lower blood pressure.
  • Angiotensin ll receptor blockers: They block the effects of angiotensin keeping the blood vessels open reducing blood pressure.
  • Alpha Blockers: These blockers help reduce the arteries’ resistance, relaxing the muscle tone of the vascular walls.
  • Alpha-2 receptor agonists: These drugs decrease the activity of the sympathetic portion of the involuntary nervous system which helps reduce blood pressure.

Lifestyle Changes

Physical Activity

By choosing to change your lifestyle and taking charge of your fitness may be one of the best decisions you’ll ever make. That choice is yours! Even moderate physical activity, like brisk walking, is beneficial to lowering elevated systolic blood pressure when done regularly (resource).

People who aren’t physically active are much more likely to have severe health issues. Regular physical activity helps to lower blood pressure, control stress, control weight and extend life expectancy. So, get off the couch and enjoy regular physical activity every day. Aim to get about 20-30 minutes of activity a day.

Physical Activities Can Include:

  • Walks
  • Yoga
  • Jogging
  • High or Low Intensity Cardio

Physical Activity Tips

  • Always consult with your physician prior to starting any exercise regimen. If you don’t have a doctor or health plan, you may want to check out my recommendation for a health plan service. They can locate an affordable plan that’s right for you. You can see my blog post about them by clicking right here.
  • Warm up before exercising and cool down afterwards. This will help your heart shift gradually from rest to activity and back again. This will also decrease your risk of injury or soreness.
  • Connect with others and consider walking with a neighbor, friend or spouse. Connecting with others can keep you focused and motivated to walk more.
  • If you love the outdoors, it’s easy to combine it with exercise and enjoy the scenery while you walk, hike or jog.
  • If you’re a music lover, enjoy your favorite music while you walk on a treadmill or use an elliptical machine.
  • Reward yourself for all your hard work, dedication and commitment to being healthy. Set goals and pay yourself for achieving them with money, gifts or things like massages. This is a great way to stay motivated and keep you moving!

systolic blood pressure


Try maintaining the potassium to sodium ratio of 4:1. The 4:1 ratio is important because your kidneys help to control your blood pressure by managing the amount of fluid stored in your body. Generally, the more fluid the higher your blood pressure. Your kidneys do this by filtering your blood and taking out any extra fluid. This process uses a delicate balance of sodium and potassium to pull out the excess water (resource).

The daily recommended amounts would be about 1,500 mg of sodium (unless you’re an athlete or have an occupation where you’re sweating all day) and 4,700 mg of potassium. Foods High In Potassium that you should eat are:

  1. Sweet Potatoes
  2. Leafy Greens
  3. Dried Apricots
  4. Beans
  5. Bananas
  6. Avocado

Magnesium causes a calming effect on your body including arteries and veins which will help prevent them from constricting which can raise systolic blood pressure (resource).

The Top 5 Foods High In Magnesium:

  1. Spinach
  2. Swiss Chard
  3. Dark Chocolate
  4. Pumpkin Seeds
  5. Almonds

The blood pressure formula I recommend contains magnesium as one of its main ingredients. If you like, check out my recommendation in this same website by clicking here.

Limit Saturated and Trans Fats

Saturated and trans fats can increase your cholesterol (resource). Foods high in these fats include:

  • Fatty red meats
  • Lamb
  • Pork
  • Chicken with skin
  • Butter
  • Cheese and other dairy products made from whole milk
  • Fast foods
  • Processed meats and food

Reduce Stress and Anxiety

Manage your stress with relaxation techniques which will help control your elevated systolic blood pressure (resource). This can include:

  • Meditation
  • Warm healing baths
  • Breathing Exercises
  • Listening to music
  • Massages or self-massages
  • Pressure points
  • Exercise
  • The proper amount of sleep

Sleeping Tips and Tricks

  • Aim for a consistent sleep schedule even on your days off.
  • Try to go to sleep and wake up around the same times every day.
  • Keep your room dark and as quiet as possible.
  • Keep the room temperature cooler than hotter. The national sleep foundation recommends the room temperature between 60 and 67 degrees.
  • Avoid tv, computer or phone screen time right before bedtime. This can stimulate brain activity and affect sleep quality.

Related Questions

What is low systolic blood pressure? The American Heart Association says there is no specific number at which blood pressure is considered too low, as long as none of the symptoms of trouble are present. Most experts define low systolic blood pressure as a systolic number less than 90 mm Hg.

Systolic vs Diastolic? The higher number is your Systolic Blood Pressure. This indicates how much pressure your blood is exerting against your artery walls when the heart beats. The lower number is your Diastolic Blood Pressure. This indicates how much pressure your blood is exerting against your artery walls while the heart is resting between beats.

Which is more important systolic or diastolic blood pressure? Research shows that both blood pressure numbers are equally important in monitoring heart health and for diagnosing high blood pressure. However, for people over 50 more attention is given to the higher number, systolic blood pressure, as a major risk factor for cardiovascular disease.


If you found this Blood Pressure topic interesting check out these related blood pressure articles also found in this same website:

Kevin Garce

Kevin Garce is a Certified Health Coach who encourages people by informing them on blood pressure topics important to them. His years of research and knowledge inspire people to achieve their goals. Read more here About Me

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