In this article, we will review the (1) epidemiology and pathophysiology, (2) risk factors and impact on outcomes, and (3) treatment goal and strategy for ISH in Asia. Thus, it is an inescapable duty for Asian physicians to recognize and manage ISH properly. 10- 14 With the rapid trend of westernized lifestyle and population aging occurring almost all countries across Asia, the burden of ISH will no doubt rise. 5, 8, 9 Many studies have demonstrated the benefit of controlling ISH even in the most elderly population.

The risk of cardiovascular disease increases substantially with uncontrolled ISH regardless of age.

4, 7 This phenomenon contributes to the high prevalence of ISH in the elderly and the increasing pulse pressure with increasing age. 4- 6 As humans age, SBP continues a linear rise but DBP starts to fall after mid-50 years of age. For young adults and adolescents, ISH is the most common form of hypertension. 2, 3 ISH is the predominant form of hypertension in the elderly but is also common in younger individuals as well. 1 Isolated systolic hypertension (ISH) is defined as systolic blood pressure (SBP) ≥ 130 mmHg and diastolic blood pressure (DBP) < 80 mmHg in the American guidelines and SBP ≥ 140 mmHg and DBP < 90 mmHg in the European and most hypertension guidelines. Hypertension is the most common modifiable risk factor for cardiovascular disease and the leading cause of morbidity and mortality across the globe.

Ish mass effect 2