Some elderly hypertensive patients may manifest as diastolic blood pressure (DBP) lower than 60mmHg, a phenomenon known as isolated systolic hypertension (ISH) with low diastolic pressure. More and more evidence shows that DBP ＜70mmHg is detrimental to the body. What’s more, the ISH patients with lower DBP often have more risk factors and are of higher risk for cardiovascular events, which become a difficulty for the treatment of the elderly hypertension. Nitrates may be a good option.