Isolated diastolic hypertension (IDH), defined as a diastolic blood pressure (DBP) > 90 mmHg and a systolic blood pressure (SBP) < 140 mmHg, is a common situation in medical practice. In the elderly, the cardiovascular risk is clearly associated with the level of systolic BP and pulse pressure. However, diastolic BP is also associated with an increased risk of cardiovascular event, in particular among young hypertensive patients (< 50 years old). Therefore, isolated diastolic hypertension should not be neglected. A careful follow-up of patients with IDH should be put in place with lifestyle changes. Sometimes, a pharmacological treatment must be started to control DBP.