Division of Renal Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA.
Hospital Privado Córdoba, Córdoba, Argentina.
Curr Cardiol Rep. 2021 Oct 16;23(12):177. doi: 10.1007/s11886-021-01609-w.
Isolated diastolic hypertension (IDH) is a frequent hypertension phenotype. We review IDH pathophysiology, risk stratification, and therapeutic decisions.
Recent guidelines lowering blood pressure cutoff levels have increased IDH prevalence and likely decreased associated cardiovascular risk. Long-term cardiovascular risk and pharmacological intervention in IDH are controversial. Narrow pulse pressure and other physiological and epidemiological characteristics are shared with a systodiastolic hypertension (SDH) subgroup. We propose that IDH be incorporated into a broader category, predominantly diastolic hypertension (PDH), defined by pulse pressure ≤ 45 mmHg and includes IDH and SDH with a narrow pulse pressure. IDH-PDH is associated with cardiovascular risk in the long term, especially in young patients. Standardization of the IDH definition and population may contribute to future research to understand genetics, pathophysiology, and eventually therapy in this important subgroup of hypertensive patients.
孤立性舒张期高血压（IDH）是一种常见的高血压表型。我们综述 IDH 的病理生理学、危险分层和治疗决策。
最近降低血压临界值的指南增加了 IDH 的患病率，可能降低了相关心血管风险。IDH 的长期心血管风险和药物干预存在争议。窄脉压和其他生理及流行病学特征与收缩舒张期高血压（SDH）亚组共享。我们建议将 IDH 纳入更广泛的类别，即主要由脉压≤45mmHg 定义的舒张期高血压（PDH），包括 IDH 和 SDH 伴窄脉压。IDH-PDH 与长期心血管风险相关，尤其是在年轻患者中。IDH 定义和人群的标准化可能有助于未来的研究，以了解这一重要高血压患者亚组的遗传学、病理生理学，最终治疗方法。
