Background: In the last years the conclusions drawn from the conducted epidemiological studies underline the role of isolated systolic hypertension in the elderly patients’ prognosis. The performed clinical trials indicated that reduction of elevated systolic blood pressure brought benefits even to elderly patients. Published results of Polish epidemiological studies, regardless that conducted in selected populations, suggest that isolated systolic hypertension may be also a health problem for the Polish population.

Material and methods: The aim of this study was to evaluate all over country prevalence of isolated systolic hypertension among patients aged above 55 years seeking medical help at out-patients clinics, to assess the relation between CHD risk factors and isolated systolic hypertension and to assess the variability of hypertension during 3 outpatient visits. Out of 430 physician randomly selected from the list of all physicians employed in Poland at out-patient clinics 346 physicians (80,5%) took part in the study, registering up to 100 consecutive patients seeking help regardless of the cause. Every patient had blood pressure taken at 3 visits and at every visit 3 measurements at supine position and 1 measurement at standing position but only second and third measurement at each visit was taken for analysis. All visits attended 22 880 patients. At the first visit the main questionnaire was filled-in.

Results: Among 22 880 patients, based on all measurements of blood pressure taken at 3 visits, prevalence of total hypertension was equal to 56,6% in men and to 59,5% in women and of systolic isolated hypertension adequately to 33,6% and 33,8%. In the analyzed age range the prevalence of total hypertension was not related with age whereas prevalence of systolic isolated hypertension increased with age up to 84 years. The variability of blood pressure was assessed in each individual patient using mean value of blood pressure measurements taken at each visit, which were statified into 4 categories: normotension, isolated systolic hypertension, systolic-diastolic hypertension and isolated diastolic hypertension. The most labile was isolated diastolic hypertension, because only 12% of patients at whom at the first visit their blood pressure was stratified as diastolic isolated hypertension remained at all 3 visit in this strata. The most stabile category was normotension because 76% of patients being normotensive at the first visit remained in this strata throughout all 3 visits. Among patients who were stratified at the first visit to the category isolated systolic hypertension 49% remained at this category throughout all 3 visits. It means that from above 30% patients, in whom isolated systolic hypertension was preliminary diagnosed during first examination half of them had the real stabile isolated systolic hypertension. Prevalence of hypertension was related with the level of obesity, total serum cholesterol level, alcoholic abstinency as well as diabetes mellitus. This positive relation dealt also with isolated systolic hypertension. Among persons with isolated systolic hypertension as well as with systolic-diastolic hypertension, however, more often cardiovascular complications were found like angina of effort, heart failure, stroke and hypertensive rethinopathy.

Conclusion: From the presented study one could draw the conclusion, that arterial hypertension and especially isolated systolic hypertension may constitute a real health problem in Polish population.