Isolated systolic hypertension

INTRODUCTION: Isolated systolic hypertension constitutes an important cardiovascular health problem, particularly in older adults, because of its association with aging and arterial stiffness, although it has traditionally been associated with advanced age, its presence is now also recognized in young adults, in whom different pathophysiological mechanisms may be involved; its course is usually asymptomatic, which may delay diagnosis and favor the development of target-organ damage and cardiovascular complications. OBJECTIVE: To analyze the available scientific evidence on isolated systolic hypertension. METHODS: A study with a nonexperimental design, of a documentary type, at a descriptive level, and in the form of a narrative literature review was conducted, scientific literature was searched in databases and specialized academic sources, prioritizing recent publications, the selected documents underwent critical reading and were organized according to the categories established in the research objectives, with a narrative synthesis of the main findings. RESULTS: The evidence reviewed showed that isolated systolic hypertension is closely related to increased arterial stiffness and loss of vascular elasticity, especially during aging, heterogeneous phenotypes were identified in young adults, including forms associated with hemodynamic alterations and peripheral amplification of systolic pressure. Likewise, the evidence showed that lifestyle modifications and appropriate pharmacological treatment reduce the risk of cardiovascular events, making it necessary to individualize therapeutic targets according to age, comorbidities, frailty, and cardiovascular risk. CONCLUSIONS: Isolated systolic hypertension constitutes a clinically relevant entity whose management requires moving beyond considering systolic pressure as an isolated finding and understanding the vascular and hemodynamic mechanisms that determine it, early identification, comprehensive cardiovascular risk assessment, and individualized treatment are fundamental to preventing complications and improving prognosis. GENERAL FIELD OF STUDY: Medicine. SPECIFIC FIELD OF STUDY: Cardiology. TYPE OF STUDY: Narrative review.