Many persons, in particular women, show a marked increase in their systolic pressure, frequently well above 160, after reaching the age of sixty, while their diastolic pressure remains normal. Their pressure range—between systolic and diastolic—is very wide. This age-related condition is not genuine hypertension but the by-product of arteriosclerotic deterioration of the major arteries, especially the aorta, and the resultant loss of elasticity. As these arteries harden and become more rigid they lose their adaptability. The walls, now inelastic, can no longer convert the blood output of the heart into a smoothly flowing stream. The result is an unbroken pulse wave with high (systolic) peaks and low (diastolic) vaileys. Here, in contrast to genuine hypertensive disease, arteriosclerosis is the cause rather than the effect of elevated blood pressure. Persons suffering from this type of circulatory disorder frequently also have diabetes, abnormal fat metabolism, are heavy smokers, and show other risk factors related to arteriosclerosis.
If their pressure does not exceed 170 mm Hg, and in the absence of other risk factors, the life expectancy of these persons is more or less normal. If, however, their readings are higher, the increased pressure may bring on congestive heart failure. In the case of advanced arteriosclerosis, just as in the case of chronic hypertension, there exists the danger of one or more typical complications.