For decades, doctors reading blood pressure tests have focused chiefly on diastolic pressure-the second, lower number-for treating hypertension and assessing the risk for cardiovascular disease.

Now the National Heart; Lung and Blood Institute (NHLBI) strongly recommends paying much more attention-especially in older people-to the first, higher number that measures systolic pressure.

Blood pressure is recorded in two numbers, for example 120/80. The systolic measures pressure as the heart contracts and the diastolic as the heart relaxes.

Current guidelines place normal blood pressure at 120/80 and high blood pressure at 140/90 and above.

With mounting evidence over nearly 30 years of the dangers of systolic hypertension, the NHLBI advisory, which appeared in Hypertension: Journal of the American Heart Association, urges doctors to concentrate more on helping at-risk patients lower systolic pressure.

Studies have shown that diastolic pressure rises until about age 55 and then declines. But systolic pressure tends to increase with age, for people middle-aged or older, says NHLBI director Claude Lenfant, M.D., it's a better gauge of the potential for heart disease and stroke.

Despite claims to the contrary, taking megadoses of antioxidant supplements such as vitamins C and E, beta carotene and selenium may not help prevent chronic disease, and, in fact, may lead to health problems.

Numerous studies have suggested that dietary antioxidants, found primarily in fruits and vegetables, help protect against cell damage that occurs in cancer, cardiovascular disease, eye disease and neurological conditions such as Alzheimer's and Parkinson's.

But a new report on Dietary Reference Intakes from the National Academy of Sciences' Institute of Medicine says there is not enough evidence to conclude that huge doses of antioxidants will prevent disease. In fact, the institute for the first time placed a ceiling on the daily consumption of vitamins C and E and selenium to reduce the risk of side effects:.

Vitamin C: Women should consume 75 miligrams and men 90 milligrams every day; smokers need another 35 milligrams. Some people take much more, but too much vitamin C can cause diarrhea. Thus the daily cap is set at 2,000 milligrams from food and supplements combined. The nutrient is found in leafy green vegetables, citrus fruit, potatoes and broccoli.

Vitamin E: Women and men need only 15 milligrams (equivalent to 22 international units, or lUs) daily from foods such as nuts, vegetable oils, liver and leafy green vegetables. In supplements, 33 lUs are recommended. Vitamin E can act as an anticoagulant and cause bleeding, so the cap is 1,500 lUs of "natural source" vitamin E or 1,000 lUs of the synthetic form.

Selenium: Women and men should take 55 micrograms, but no more than 400 micrograms from supplements and food sources (seafood, liver, meat and grains) combined. Too much selenium can cause hair loss and nail sloughing. The institute did not issue guidelines on beta carotene consumption.

A simple, inexpensive blood test may predict heart disease more accurately than cholesterol screening.

The new test measures inflammation by targeting a marker know as hs-CRP (high-sensitivity C-reactive protein). Plaque, which builds up in the blood vessels and produces atherosclerosis, or hardening of the arteries, produces an inflammatory response if it becomes unstable. The plaque can rupture and form a clot that results in a heart attack.

Researchers from Brigham and Women's Hospital in Boston tracked women in the Women's Health Study for three years after they took the hs-CRP test. They compared 122 who had heart attacks with 244 participants who did not. The 25 percent with high levels of the protein were 4.4 times as likely to have cardiovascular problems as the 25 percent with the lowest levels. Other studies indicate the test would work as well on men and on premenopausal women.

The protein test, which, unlike cholesterol tests, can predict the risk for stroke as well as heart disease, costs $15 to $20. It has been approved by the Food and Drug Administration. In a PBS interview, lead study author Paul Ridker, M.D., of Harvard Medical School said, "Cholesterol levels remain very important." Whether individuals have high cholesterol or high protein levels, or both, they are at risk.