- With Mayo Clinic emeritus hypertension specialist
Sheldon G. Sheps, M.D.
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Sheldon G. Sheps, M.D.
Sheldon G. Sheps, M.D.
Dr. Sheldon Sheps, emeritus professor of medicine and former chair of the Hypertension Division in the Department of Medicine at Mayo Clinic, has been with Mayo Clinic since 1960.
Dr. Sheps, a Winnipeg, Manitoba, native, is board certified in internal medicine and specializes in hypertension and peripheral vascular diseases. He developed a multidisciplinary approach with specially trained nurses, dietitians, technicians and educators to help form a team approach to the treatment of patients with abnormal blood pressure.
"I have always believed in involving the patient and family in their health care," he says. "I have asked for their understanding of the illness and issues and for participation in decisions. The Web is a natural extension of that, and now many more people can be informed."
Dr. Sheps chaired the sixth working group, and participated in the fourth, fifth and seventh groups, that developed the then-latest guidelines for hypertension under the auspices of the National Heart, Lung and Blood Institute (NHLBI). He helped write the latest American Heart Association (AHA) report on blood pressure measurement. He chaired an AHA group that produced an online accreditation for blood pressure measurement for health professionals. He has co-authored books, newsletters, CD-ROMs and other Mayo Clinic health information material and joined Mayo Clinic's Web team in 1998. He was medical editor-in-chief of both editions of the "Mayo Clinic on High Blood Pressure" book; the last edition was published in 2003. He was also medical editor-in-chief of "Mayo Clinic 5 Steps to Controlling High Blood Pressure,'' published in 2008.
He was section editor for each of the first three editions of "Hypertension Primer" for the American Heart Association.
Dr. Sheps was also chairman of the Science Base Subcommittee, National High Blood Pressure Education Program, and was a consultant to the Hypertension Initiative of the World Health Organization. In 1997, he was honored with the Individual Achievement Award on the 25th anniversary of the National High Blood Pressure Education Program of NHLBI. In 2009, he was honored as a Distinguished Mayo Alumnus.
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Question
Isolated systolic hypertension: A health concern?
My doctor says my diastolic pressure is fine but my systolic pressure is too high. I thought diastolic pressure was the more important number?
Answer
from Sheldon G. Sheps, M.D.
For years, doctors focused primarily on diastolic blood pressure — which is the bottom number in a blood pressure reading. The theory was that the body could tolerate occasional increases in systolic blood pressure, but consistently high diastolic pressure could lead to organ damage. However, doctors now know that high systolic pressure is as important as high diastolic pressure — and even more important in people older than age 50.
If you have a diastolic number less than 90 millimeters of mercury (mm Hg) and a systolic number greater than 140 mm Hg, you have a common type of high blood pressure called isolated systolic hypertension. Isolated systolic hypertension can lead to serious health problems, such as stroke, heart disease, chronic kidney disease and dementia, and should be treated in the same way as regular high blood pressure.
The recommended goal for systolic pressure is less than 140 mm Hg. However, a concern in people with isolated systolic hypertension is that treatment may lower diastolic pressure too much, increasing the risk of a cardiovascular event. For this reason, caution is advised in treating isolated systolic hypertension in people with existing heart disease. Diastolic pressure should not be reduced to less than 70 mm Hg to attain the target systolic pressure.
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