Isolated Diastolic Hypertension and Risk of Cardiovascular Disease: Controversies in Hypertension - Pro Side of the Argument

Yuichiro Yano, Hyeon Chang Kim, Hokyou Lee, Nazar Azahar, Sabrina Ahmed, Kaori Kitaoka, Hidehiro Kaneko, Fujimi Kawai, Atsushi Mizuno, Anthony J. Viera

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)


Isolated diastolic hypertension (IDH), defined as diastolic blood pressure in the hypertensive range but systolic blood pressure not in the hypertensive range, is not uncommon (<20%) among adults with hypertension. IDH often manifests in concurrence with other cardiovascular risk factors. Individuals with IDH tend to have lower awareness of their hypertension compared with those with both systolic and diastolic hypertension. IDH appears to be a largely underrated risk factor for cardiovascular disease events, which may be explained by inconsistent association of IDH with cardiovascular disease events. The inconsistency suggests that IDH is heterogeneous. One size does not seem to fit all in the clinical management of individuals with IDH. Rather than treating IDH as a monolithic low-risk condition, detailed phenotyping in the context of individual comprehensive cardiovascular risk would seem to be most useful to assess an individual's expected net benefit from therapy. In this review, we highlight that the clinical relevance of IDH differs by individual clinical characteristics, and elucidate groups of individuals with IDH that should be wary of cardiovascular disease risks.

Original languageEnglish
Pages (from-to)1563-1570
Number of pages8
Issue number8
Publication statusPublished - 2022 Aug 1

Bibliographical note

Funding Information:
Y. Yano received research grant from Boehringer Ingelheim, consulting fee from AstraZeneca and KOWA, and speaking honorarium from Bayer, Daiichi-Sankyo, Takeda, and Novartis. H. Kaneko received research funding and scholarship funds from Medtronic Japan CO., LTD, Boston Scientific Japan CO., LTD, Biotronik Japan, Simplex QUANTUM CO., LTD, and Fukuda Denshi, Central Tokyo CO., LTD. The other authors report no conflicts.

Publisher Copyright:
© 2022 Lippincott Williams and Wilkins. All rights reserved.

All Science Journal Classification (ASJC) codes

  • Internal Medicine


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