Isolated systolic hypertension is defined by

• A. Systolic BP >140 with diastolic >90.
• B. Systolic BP >140 with diastolic <90.
• C. Diastolic >90 with normal systolic.
• D. Pulse pressure >60.

Answer: (B)

Isolated systolic hypertension means the systolic pressure is high while the diastolic pressure stays normal or low, creating a widened pulse pressure. This pattern typically arises in older adults when arteries stiffen, causing the top number to rise but the bottom number to stay low. The defining combination here is a systolic pressure above 140 mmHg with a diastolic pressure below 90 mmHg. A high systolic with high diastolic would be a different form of hypertension, and a high diastolic with a normal systolic is diastolic hypertension. A wide pulse pressure can occur with ISH but isn’t the diagnostic criterion by itself.