Isolated systolic hypertension

Abstract

Introduction. Isolated systolic hypertension constitutes an important cardiovascular health problem, particularly in older adults, due to its association with aging and arterial stiffness. Although it has traditionally been associated with advanced age, its presence in young adults is also currently recognized, in whom different pathophysiological mechanisms may be involved. Its progression is usually asymptomatic, which may delay diagnosis and contribute to the development of target-organ damage and cardiovascular complications. Objective. To analyze the available scientific evidence on isolated systolic hypertension. Methodology. A non-experimental, documentary, descriptive-level study was conducted using a narrative literature review approach. A search for scientific literature was conducted in databases and specialized academic sources, prioritizing recent publications. The selected documents were critically reviewed and organized according to the categories established in the research objectives, followed by a narrative synthesis of the main findings. Results. The reviewed evidence showed that isolated systolic hypertension is strongly associated with increased arterial stiffness and loss of vascular elasticity, particularly during aging. In young adults, heterogeneous phenotypes were identified, including forms associated with hemodynamic alterations and peripheral amplification of systolic blood pressure. Likewise, the evidence demonstrated that lifestyle modifications and appropriate pharmacological treatment reduce the risk of cardiovascular events. Therefore, therapeutic targets should be individualized according to age, comorbidities, frailty, and cardiovascular risk. Conclusion. Isolated systolic hypertension is a clinically relevant condition whose management requires moving beyond the consideration of systolic blood pressure as an isolated finding and understanding the vascular and hemodynamic mechanisms underlying it. Early identification, comprehensive cardiovascular risk assessment, and individualized treatment are essential to prevent complications and improve prognosis. General Area of Study: Medicine. Specific area of study: Cardiology. Type of study: Narrative review.