Isolated systolic hypertension is most commonly seen in which population?

• A. It is common in infants.
• B. It rarely occurs in the elderly.
• C. Isolated systolic hypertension is common in older adults.
• D. It is primarily a diastolic hypertension issue in middle age.

Answer: (C)

Isolated systolic hypertension happens when the top number is high but the bottom number stays normal or low. This pattern arises most often in older adults because aging makes the aorta and large arteries stiffer and less compliant. When arteries lose elasticity, the pressure during heart contraction (systole) rises more than the pressure during relaxation (diastole), so systolic pressure goes up while diastolic pressure remains normal or even falls. That wide pulse pressure is characteristic of ISH and explains why it’s most common in the elderly. Infants don’t typically show this pattern, and in middle age diastolic issues or combined hypertension are more typical, not isolated systolic hypertension.