Isolated systolIc hypertensIon

Until the 1980’s the diastolic blood pressure (DBP) was assumed to be the most relevant hemodynamic parameter for prognosis of hypertensive patients. Elevated systolic pressure was considered as an inevitable consequence of aging and many physicians were reluctant to pay credence to the need for therapy of elevated systolic blood pressure. There was a radical change in thinking based on epidemiological studies and reports by insurance companies which led to recognition of elevated systolic blood pressure (SBP). The term isolated systolic hypertension (ISH) has been introduced particularly in elderly subjects, since SBP is known to rise with advancing age; where as diastolic blood pressure (DBP) usually levels off and tends to decrease in elderly.1 According to the National Health and Nutrition Examination Survey (NHANES) III, ISH is the most prevalent type of untreated hypertension over 60 years of age. ISH represents a substantial health care problem as the target BP is very difficult to attain by drug therapy.