The divergent trajectories of systolic and diastolic blood pressure after age 60 are mechanistically linked to increased large artery stiffness, highlighting the importance of treating higher systolic blood pressure to prevent a vicious cycle of vascular aging.
The late fall in DBP after age 60 years, associated with a continual rise in SBP, cannot be explained by "burned out" diastolic hypertension or by "selective survivorship" but is consistent with increased large artery stiffness. Higher SBP, left untreated, may accelerate large artery stiffness and thus perpetuate a vicious cycle.
Franklin et al. (Tue,) studied this question.