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Is Isolated Diastolic Hypertension an Important Phenotype?

Cesar A Romero1, Aldo H Tabares2, Marcelo Orias3

  • 1Division of Renal Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA.

Current Cardiology Reports
|October 17, 2021
PubMed

Insights

Isolated diastolic hypertension (IDH) is common. A new category, predominantly diastolic hypertension (PDH), is proposed to include IDH and narrow pulse pressure systolic-diastolic hypertension, aiding future research and therapy.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Clinical Medicine

Background:

  • Isolated diastolic hypertension (IDH) is a frequent phenotype.
  • Recent guideline changes have increased IDH prevalence.
  • The long-term cardiovascular risk and treatment of IDH remain debated.

Purpose of the Study:

  • To review the pathophysiology, risk stratification, and therapeutic decisions for IDH.
  • To propose a broader category for diastolic hypertension.
  • To highlight the need for standardized definitions in IDH research.

Main Methods:

  • Review of existing literature on IDH.
  • Analysis of physiological and epidemiological characteristics.
  • Comparison of IDH with systolic-diastolic hypertension (SDH) subgroups.

Main Results:

  • Lowered blood pressure cutoffs increase IDH prevalence.
  • IDH shares characteristics with a subgroup of SDH.
  • A proposed category of predominantly diastolic hypertension (PDH) includes IDH and narrow pulse pressure SDH.
  • PDH is linked to long-term cardiovascular risk, particularly in younger individuals.

Conclusions:

  • IDH and narrow pulse pressure SDH may be grouped as PDH (pulse pressure ≤ 45 mmHg).
  • This broader classification may improve understanding of cardiovascular risk.
  • Standardization of IDH definitions is crucial for future research into genetics, pathophysiology, and treatment.
Abstract

Keywords:
Hypertension in young patientsHypertension prognosisIsolated diastolic hypertensionNarrow pulse pressurePredominantly diastolic hypertension

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