When hypertension is diagnosed in middle age, the most common blood pressure pattern is elevated diastolic pressure with systolic pressure being either normal or elevated (combined systolic/diastolic hypertension).
Isolated diastolic hypertension is more common in men and often associated with middle-age weight gain and the metabolic syndrome. It is also linked to a high heart rate and cardiac output suggesting high sympathetic nerve activity. It may account for up to 14% of hypertension in the elderly.
Isolated diastolic hypertension is thought to evolve primarily from normal or high-normal blood pressure. Follow up suggest that individuals with isolated diastolic hypertension later develop mixed systolic diastolic hypertension.
Isolated diastolic hypertension does not have any significant impact on the clinical sequelae of hypertension. Beyond the age of 60, a decrease in diastolic blood pressure and a wide pulse pressure have correlated with an increased cardiovascular risk.
Isolated diastolic hypertension
