What condition is indicated by a systolic pressure of 158 and a diastolic pressure of 64 in an older adult?

Isolated systolic hypertension is characterized by a high systolic blood pressure (above 130 mmHg) while the diastolic pressure remains within normal limits (typically less than 80 mmHg). In this scenario, the systolic pressure of 158 indicates clearly elevated systolic levels, while the diastolic pressure of 64 falls within the normal range. This condition is particularly common in older adults, often due to age-related changes in blood vessel elasticity and other cardiovascular factors. It is important to monitor and manage isolated systolic hypertension because, despite normal diastolic levels, the elevated systolic pressure can lead to an increased risk of cardiovascular events such as stroke or heart attack, especially in the elderly population.

The other options presented do not appropriately describe this blood pressure reading. Hypertensive urgency typically requires a significantly elevated diastolic pressure as well. Orthostatic hypotension involves a drop in blood pressure upon standing and does not fit the provided readings. Stage 2 hypertension requires both systolic and diastolic pressures to be elevated, which is not the case here, as the diastolic is normal.