How to lower systolic blood pressure

Last reviewed:
08 Jul 2022
Medically reviewed by:

How to Lower Systolic Blood Pressure

Blood pressure is measured in two numbers: the top number (systolic blood pressure) over the bottom number (diastolic blood pressure). When these numbers are higher than normal, you have high blood pressure (hypertension). But what’s more important, systolic or diastolic blood pressure? And what if your systolic blood pressure is high and your diastolic blood pressure is normal?

This guide will, we’ll explain more about systolic blood pressure and isolated systolic hypertension (ISH), together with the causes and treatments, including the lifestyle changes you can make to help reduce systolic blood pressure.

What is systolic blood pressure?

You probably already know the difference between systolic and diastolic blood pressure. Systolic pressure is the force the heart uses to pump blood out to the body; diastolic pressure is the pressure in your blood vessels between beats.

Both numbers in your blood pressure reading are equally important when it comes to diagnosing and treating hypertension. However, as Harvard Medical School confirms, most studies show that a high systolic blood pressure carries a greater risk of stroke and heart disease than elevated diastolic pressures, especially in people over 50.

Here’s how to understand your systolic blood pressure number:

According to European Society of Cardiology (ESC) and the European Society of Hypertension guidelines, blood pressure classification is as below:

Category Systolic (mmHg) Diastolic (mmHg)
Optimal Less than 120
Normal 120 – 129
High normal 130 – 139
Grade 1 hypertension 140 – 159
Grade 2 hypertension 160 – 179
Grade 3 hypertension Higher than 180
Isolated systolic hypertension Higher than 140

Source: ESC/ESH Guidelines for the management of arterial hypertension,

Understanding isolated systolic hypertension

Isolated systolic hypertension (ISH) is when you have a high systolic blood pressure reading (140 or higher) and a normal diastolic blood pressure reading (less than 80). Even though only one number is elevated, ISH is still considered a type of high blood pressure. It’s actually the most common type of high blood pressure in people aged 65 and over.

Like other types of high blood pressure, ISH can increase the risk of a range of health conditions, including heart attack, stroke, kidney disease and heart failure.

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What causes isolated systolic hypertension?

There’s often no identifiable cause of isolated systolic hypertension other than simply getting older. As we age, the arteries become less elastic. They may also become stiffer due to fatty deposits on the artery wall, known as plaque.

Sometimes, ISH is developed as a result of another medical condition affecting the circulatory system. These include: 

  • Anemia. Here, there aren’t enough red blood cells to carry oxygen to the tissues of the body. This causes the heart to work harder, meaning blood vessels can become damaged.
  • Diabetes. High glucose levels in the blood can lead to conditions that affect the heart and circulatory system.
  • Hyperthyroidism. An overactive thyroid means the body has more thyroid hormones than is needed. This can affect almost every organ, including the heart and circulatory system.
  • Obstructive sleep apnea. Muscles in the throat block the airway during sleep, causing your breathing to stop and start. This can put the cardiovascular system under extra strain, leading to increases in blood pressure.

You may also be more likely to develop ISH if:

  • You are overweight
  • You have a high salt intake
  • You smoke (this can stiffen the arteries)
  • You’re a heavy drinker
  • Your parents had high blood pressure

How can you treat isolated systolic hypertension?

Like other forms of high blood pressure, the key to treating ISH is a sensible combination of lifestyle changes, medication, or both. If an underlying condition is causing or contributing to ISH, your doctor will work to treat that as well.

Your doctor will let you know whether medication to lower systolic blood pressure is a good option for you. Either way, they’ll likely advise you to make a few lifestyle changes to help manage the condition and improve your general health. These may include:

  • Losing weight, if applicable
  • Eating a healthy diet, rich in vegetables, whole grains, lean protein and low-fat dairy. Take a look at the Dietary Approaches to Stop Hypertension (DASH) diet, which is designed to prevent or treat high blood pressure
  • Reducing salt in your diet. A high sodium intake is associated with high blood pressure, so reducing the amount of salt you use can take some strain off your blood vessels and heart.
  • Exercising. Not only can exercise help you lower your blood pressure, but it can also help you manage your weight and stress levels.
  • Drinking less alcohol. Over time, heavy drinking can cause blood vessels to become narrower, making it harder for blood to pump around your body
  • Quitting smoking. The nicotine in cigarettes raises blood pressure and heart rates in a similar way to alcohol, by narrowing your blood vessels. It can also harden artery walls and increase the risk of blood clot
  • Managing stress. Stress can raise your blood pressure, so find something you enjoy and that makes you feel more relaxed.

Final thoughts

High blood pressure is known as ‘the silent killer’ because it typically has no symptoms or warning signs. The only way to know whether your blood pressure is too high is to get it measured when you visit your GP, at a pharmacy, or at home, with a home blood pressure monitor.

Understanding your blood pressure and monitoring changes is an important step towards taking control of your health. You might want to take a look at our guide, how to use a blood pressure monitor as well as our Blood Pressure Monitor Buying Guide.

Disclaimer: If you have hypertension, we encourage you to speak to your healthcare professional if you plan to rely solely on blood pressure monitoring as a means of tracking your condition.


Which blood pressure number is important?, February 15, 2021 –

Systolic Hypertension, August 8, 2022 –

Medically Reviewed

dr jay shah photo

Renowned cardiologist, physician leader, and angel investor.

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