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Although many doctors have long treated patients on the basis of the diastolic reading?the bottom number in a blood pressure reading?a new study in Paris has concluded that the top, or systolic, number is a better predictor of heart attack and stroke risk in men.
The diastolic number has long been viewed as the more sensitive indicator of hypertension and has thus been the focus of most therapies. However, as reported in the March 11, 2002, issue of Archives of Internal Medicine, a French study found that patients with uncontrolled systolic blood pressure were two and a half times more likely to die of heart disease than those under treatment for high diastolic pressure.
?Our results show that in clinical practice,? the report concludes, ?a well-controlled systolic blood pressure (less than 140 mm Hg) should be the goal of anti-hypertensive treatment.? In an accompanying editorial, Dr. Prakash C. Deedwania of the University of California, San Francisco, noted, ?It is also important to emphasize that often more than one, but usually two or three drugs are needed to achieve optimal control of systolic blood pressure.?