Isolated Systolic Hypertension in Young and Middle-Aged Adults

Yuichiro Yano, Donald M Lloyd-Jones*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

13 Scopus citations


Young and middle-aged adults (ages ≤50 years) are increasingly prone to stroke, kidney disease, and worsening cardiovascular disease (CVD) mortality. An alarming increase in the prevalence of high blood pressure (BP) may underlie the adverse trend. However, there is often uncertainty in BP management for young and middle-aged adults. Isolated systolic hypertension (ISH) is one such example. Whether ISH in young and middle-aged adults represents “pseudo” or “spurious” hypertension is still being debated. ISH in young and middle-aged adults is a heterogeneous entity; some individuals appear to have increased stroke volume, whereas others have stiffened aortae, or both. One size does not seem to fit all in the clinical management of ISH in young and middle-aged adults. Rather than treating ISH as a monolithic condition, detailed phenotyping of ISH based on (patho)physiology and in the context of individual global cardiovascular risks would seem to be most useful to assess an individual expected net benefit from therapy. This review provides an overview of the current understanding of ISH in young and middle-aged adults, including the prevalence, pathophysiology, and treatment.

Original languageEnglish (US)
Article number78
JournalCurrent hypertension reports
Issue number11
StatePublished - Nov 1 2016


  • Aortic stiffness
  • Central blood pressure
  • Isolated systolic hypertension
  • Pressure amplification
  • Young and middle-aged adults

ASJC Scopus subject areas

  • Internal Medicine


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