Geriatric Medicine pp 251-261 | Cite as
Isolated Systolic Hypertension
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Abstract
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ISH is diagnosed when systolic blood pressure is more than 140 mmHg with a normal or low diastolic pressure (less than 90 mmHg).
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Prevalence of ISH increases with age, and it is one of the special problems in hypertension among geriatric population.
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Contrary to traditional thinking, systolic hypertension is a strong predictor of cardiovascular morbidity and mortality.
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Increased arterial stiffness resulting in augmented reflection of the pulse wave is the major pathophysiological mechanism in ISH along with functional changes like endothelial dysfunction, enhanced sympathetic tone, and abnormal sodium hemostasis.
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Management of ISH can be a challenge, and drugs which reduce the augmentation index play a pivotal role in refractory cases.
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