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What is isolated diastolic hypertension ?

Posted Feb 10 2009 11:30am




  • Hypertension  is  major determinant of cardiovascular health  of our global population 
  • Millions suffer,   hundreds of societies ,  and as many guidelines , and drugs are still struggling  to control the menace.
  • An important sub group of HT , (ie IDH ) population has been neglected and never received the scientific interest , which it deserves !
  • In our study it occured in 7.2% of all HT  patients.
  • JNC,  the world authority on HT never considered  IDH as a separate entity, and as of now there is no specific guidelines.
  • And the irony is complete, as on today there is not  a  major study available to analyse the differential effects of anti hypertensive drugs on systolic and diastolic blood pressure.

If  a patient with the BP of 120/96 asks you , “Doctor , will the drug,   you have prescribed , selectively lower my diastolic blood pressure ”  what will be your answer ?

A clear ,  I don”t know !

The following paper was presented in the World congress of cardiology Sydney  2002

Isolated   Diastolic Hypertension  

S.Venkatesan,S.D.Jayaraj.Gnanavelu,  Madras Medical College. Madras, India. 

  Abstract : Systemic   hypertension   continues to   be a major determinant of cardiovascular   morbidity. While isolated systolic hypertension(ISH) has been identified as a specific clinical entity, isolated   diastolic   hypertension(IDH) has not been reported as a separate group. When we analysed our data from our hypertension    clinic   we found   a distinct subgroup of patients who had   elevated   diastolic blood pressure    with   normal systolic pressure. We report the clinical profile of these patients. 440 newly registered hypertensive   patients between the year 1998-99   formed the study population. All   patients with secondary hypertension   were excluded.. IDH   was defined as   diastolic BP more than 90mmhg and systolic BP less than 140mmhg.

IDH was present in 32(7.2%) patients.   The male female ratio was 3:1, mean age was 42(Range32-56) The mean diastolic pressure was 96 mm (Range 90-110).The mean systolic pressure was 136mm(Range 128-140). LVH was observed in 4 patients(12.5%). Diastolic dysfunction was detected by echocardiography    in 20patients.(62%)

                           We conclude that isolated diastolic hypertension   constitute a   significant subset among   hypertensive   patients and they need further study regarding the pathogenesis, clinical   presentation and   therapeutic implication.


 Link to PPT  will be available soon .







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