Hypertension is the leading risk-factor for cardiovascular disease and death from them. Traditionally, the problem of isolated systolic hypertension is associated with old age in mind the natural dynamics of systolic and diastolic blood pressure throughout life. Isolated systolic hypertension is the most common type of hypertension in elderly men as well as young adults. The pathophysiology of this condition in different age periods have fundamental differences. The adverse prognostic significance of isolated systolic hypertension in the elderly, and the need for its non-drug and drug treatment are well documented. Accumulating epidemiological evidence on the adverse prognostic significance of isolated systolic hypertension. People young and middle-aged isolated systolic hypertension heterogeneous and may be a consequence of excessive pulse pressure amplification from the aorta to the peripheral arteries and the manifestation of an accelerated aging. Evaluation of central blood pressure and arterial stiffness in young may help identify premature vascular aging.