Is the Cardiovascular Risk Increased in Patients with Isolated SystolicHypertension and Anemia?

Introduction: Isolated systolic hypertension (ISH) is important because of its very high prevalence. Anemia is also a highly prevalent non-communicable disease. The paper aims to answer the study questions: 1) Is there a relation between anemia and dBP?; 2) Is there a link between ISH and anemia?; 3) Are ISH and anemia important due to their prevalence?; 4) Is the cardiovascular risk increased in ISH patients with anemia?5) Is this recognized in HTN guidelines? Methods: Search 1 was done for ‘isolated systolic hypertension’ and ‘anemia’ in papers (excluding guidelines). Search 2 was performed for arterial hypertension (HTN) guidelines, to see if there is a part about ‘isolated systolic hypertension’ and about ‘anemia’, as well as about their relationship. We performed a SCOPUS, Springer Verlag, Elsevier, PubMed, and Google Scholar search Results: Diastolic blood pressure is often decreased in anemia, due to abundant pathophysiological mechanisms. Moreover, dBP is often low in both ISH and anemia. Third, anemia and ISH are important due to their high prevalence, especially in the elderly. Discussion: The main result of the study is the identification of the important, clinically relevant, previously undefined problem: anemia in ISH. Cardiovascular risk is increased in ISH patients with anemia. The significance of anemia in ISH is not recognized in HTA guidelines, partially because they need to be concise. Conclusion: The overlooked problem of anemia in ISH needs recognition both in clinical practice, to avoid overzealous dBP reduction even more carefully in ISH patients with anemia, and in a scientific way, to be studied thoroughly.