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[What can we think about diastolic hypertension?]
1Service de Médecine Interne et Hypertension Artérielle, CHU Purpan, Toulouse.
Annales De Cardiologie Et D'Angeiologie
|December 1, 1995
Summary
Isolated diastolic hypertension, a condition affecting younger individuals, involves elevated diastolic pressure without high systolic pressure. Specific medications like ACE inhibitors are recommended over others for this hypertension type.
Area of Science:
- Cardiology
- Vascular Biology
Context:
- Isolated diastolic hypertension (IDH) is not a formally recognized hypertensive disorder.
- IDH is characterized by diastolic pressure > 90 mm Hg and systolic pressure < 140 mmHg.
- This condition reflects increased arteriolar resistance with preserved large vessel compliance, typically seen in younger patients without significant vascular aging factors.
Purpose:
- To define isolated diastolic hypertension (IDH).
- To explore the underlying pathophysiology of IDH.
- To suggest optimal pharmacological management strategies for IDH.
Summary:
- IDH is defined by specific pressure thresholds and implies arteriolar vasoconstriction with maintained aortic distensibility.
- Pathophysiologically, it may involve increased adrenergic tone or plasma renin activity without impaired systolic function.
- Recommended treatments include angiotensin-converting enzyme inhibitors and calcium channel blockers, potentially more effective than diuretics or beta-blockers.
Impact:
- Clarifies the definition and characteristics of isolated diastolic hypertension.
- Provides insights into the pathophysiology, differentiating it from other hypertensive forms.
- Offers evidence-based recommendations for pharmacotherapy, guiding clinical practice for a specific patient group.