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Isolated systolic hypertension (ISH)

As adults grow older, systolic BP tends to rise and diastolic BP tends to decrease. When the average systolic BP greater than or equal to 140 and average diastolic BP below 90 mmHg the patient is classified as having an HSA. The growth of the pulse pressure (systolic minus diastolic) and systolic pressure predict risk and determine treatment.

Isolated systolic hypertension in young patients

In older children and young adults, males more often in the combination of rapid statural growth and high elasticity of the arteries accentuates the normal amplification of the pulse wave between the aorta and the brachial artery (which measures the PA) resulting in a high systolic pressure in the brachial artery but with normal diastolic and mean pressures. However, aortic systolic pressure is normal.

Isolated diastolic hypertension (HDA)

It is more common in young adults. Is defined as systolic BP less than 140 mmHg and diastolic BP less than 90 mmHg. Although it is generally believed that diastolic blood pressure is the best predictor of risk in patients younger than 50 years, some prospective studies of isolated diastolic hypertension have concluded that his prognosis may be benign. This issue is still under dispute.

White coat hypertension (WCH) or hypertension in isolation from the consultation

Commonly defined as the persistence of a high average PA in the office of more than 140/90 mmHg and the presence of ambulatory readings to wake up to an average of less than 135/85 mmHg. Occurs between 15-20% of the spersonas with stage 1 hypertension. Patients with WCH may progress to sustained hypertension and need to be followed carefully by both BP readings and in home consultation.

Masked hypertension or isolated ambulatory hypertension

It is less frequent than before but more problematic to be detected, the condition is the reverse of the white coat: a normal BP in the office and elevated BP at home or at work. There is evidence that such patients have an increased target organ damage and has a higher risk than subjects who remained normotensive throughout the time.

Pseudohipertension

In a small number of elderly patients, the muscular arteries of the periphery become very rigid, so that the cuff should be at a higher pressure to compress the radial or brachial artery can even be felt in a distal to fully inflated cuff (positive Osler sign). Although this maneuver is not a reliable method for screening pseudohipertensión.

Orthostatic or postural hypotension

It is defined as systolic BP reduction of at least 20 mmHg and diastolic pressure by at least 10 mmHg to 3 minutes after orthostasis stay (standing). If there is a chronic, may be due to a problem of regulation of the autonomic nervous system. These patients may have a profound hypotension when standing, severe hypertension when they sleep at night.

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