Isolated systolic hypertension as a treatable risk factor

Isolated systolic hypertension (ISH) is characterised by elevated systolic (SBP) and somewhat lowered diastolic blood pressure (DBP). ISH occurs predominantly in elderly hypertensives as a result of aortic stiffness, which increases with age. Elevated SBP and even more so widened pulse pressure (PP=SBP-DBP) are recognised as important risk factors for stroke and ischaemic heart disease. ISH therefore requires consistent drug therapy, combined with lifestyle advice. It is important to lower SBP without reducing DBP too much, in order to avoid a further widening of the PP