Current approach to isolated diastolic hypertension

In various guidelines, isolated diastolic hypertension is defined as diastolic blood pressure >80 or >90mmHg in individuals with normal systolic blood pressure. While isolated diastolic hypertension was associated with adverse cardiovascular events in observational studies, this relationship is not clear in epidemiological studies. Increased arterial stiffness, increased central hemodynamics, vasoconstriction, increased adrenergic activity, increased renin angiotensin aldesteron activity play a role in the pathophysiology. Isolated diastolic hypertension is associated with male gender, young age, increased body mass index, increased glucose level, increased alcohol consumption and high triglyceride levels. Although treatment is not recommended in young people in isolated diastolic hypertension, treatment should be individualized according to the underlying cardiovascular disease in the elderly.