Global Prevalence of Isolated Systolic, Isolated Diastolic, and Systodiastolic Hypertension: A Systematic Review and Meta-Analysis

Arterial hypertension (HTN) is a global public health problem with three distinct subtypes: isolated systolic hypertension (ISH), isolated diastolic hypertension (IDH), and systodiastolic hypertension (SDH), each with unique clinical implications. This systematic review and meta-analysis aimed to determine the global prevalence of ISH, IDH, and SDH and their variability. Following PRISMA guidelines, a search was conducted in SCOPUS, Web of Science, PubMed, and EMBASE. A random-effects model with the Freeman-Tukey transformation was used for the meta-analysis, and a meta-regression was performed to assess temporal trends. Twenty-seven studies from five continents were included, revealing pooled global prevalence rates of 10.72% for ISH, 5.07% for IDH, and 11.71% for SDH. Extreme heterogeneity was observed (I2 = 100%), reflecting substantial methodological diversity. The meta-regression suggested an increasing trend for ISH over time, while non-significant decreasing trends were observed for IDH and SDH. In conclusion, all three HTN subtypes show clinically relevant prevalences, with ISH and SDH being nearly twice as common as IDH. The high heterogeneity underscores the urgent need for research standardization, and these findings highlight the importance of differentiating subtypes for more effective population-level screening and public health planning.