On aging, arterial stiffness increases and systolic blood pressure (SBP) rises, whereas diastolic blood pressure (DBP) remains flat, leading to isolated systolic hypertension (ISH) in the elderly. A shorter height may cause the reflected wave to return even faster, and promote ISH. We evaluated the determinants of ISH.Design and Method:
We included 3,857 subjects over 50 years old from the Ansan-Ansung cohort between 2001 and 2002. We evaluated the prevalence of ISH and compared clinical differences between the ISH group (n = 241) and systolic- diastolic hypertension group (n = 1,707).Results:
Compared to the systolic-diastolic hypertension group, the ISH group was older, drank less alcohol, smoked less, and also, was 2 cm shorter (156.2 ± 8.3 cm vs. 158.0 ± 8.7 cm, p = 0.001). Meanwhile, there were no significant differences in metabolic status between the two groups. Then we divided the cohort into three tertiles according to height. In both men and women, the prevalence of ISH was significantly higher in the shortest tertile (6.9% and 8.1%) compared to that in the tallest tertile (4.1% and 4.9%) (p < 0.001), and this tendency remained on follow-up. In men and women, SBP in the shortest tertile was 2.9 mmHg and 4.4 mg higher than that of the tallest tertiles (130.7 mmHg vs. 127.8 mmHg for men, 128.9 mmHg vs. 133.3 mmHg for women, p < 0.05), while mean DBP was not significantly different across the tertiles. There was a 0.3 mmHg increase in SBP for every 1 cm decrease in height on multivariate analysis (p < 0.05).Conclusions:
We found that shorter height was associated with an increased risk of ISH in the elderly population, by causing an increase in SBP. Interestingly, ISH was not associated with parameters of metabolic status.