G.D. Radchenko, O.O. Torbas, Yu.M. Sirenko.Isolated systolic hypertension in young people: do we have to treat all of them?

The aim – to find and evaluate factors open for wide usage, significantly and independently associated with probability of elevated central blood pressure (BP) in young subjects with isolated systolic hypertension (ISH).

Material and methods. The study included 44 young men (mean age 32.2±1.3 years) with office systolic blood pressure (SBP) ≥ 140 mmHg and office diastolic blood pressure (DBP) < 90 mm Hg (average 153.4±2.1 mmHg and 83.4±1.7 mm Hg, respectively). Following procedures were performed in all subjects: body weight and height evaluation, measuring of office SBP, DBP and heart rate, ambulatory blood pressure monitoring, measurement of pulse wave velocity in arteries of elastic (PWVe) and muscle types, central SBP (CSBP) measurement, biochemical blood tests, electrocardiography, echocardiography and carotid ultrasound. Results. Depending on the CSBP level all patients were divided into two groups: the 1st (n=17) – subjects with normal CSBP, the 2nd (n=27) – with elevated CSBP. Patients of group 2 were significantly older, with less height and higher body mass index (BMI), they had significantly higher levels of office SBP and DBP. Characteristics of target organ damage were within normal limits in both groups and did not differ significantly. PWVe was significantly higher in group 2. The independent predictors of elevated CSBP were height ≤ 178 cm (β=7.038, P=0.05, CI 1.09–52.5), body weight ≥ 91 kg (β=5.53, P=0.033, CI 1.14–26.7) and level office DBP ≥ 80 mm Hg (β=4.43, P=0.05, CI 1.06–20.44). The presence of two or three of these factors increased the risk of increased office SBP by 10 times (β=10.6, P=0.001, CI 2.54–43.9). Conclusion. 38.6 % of young people with ISH have normal СSBP. Independent predictors of increased office SBP included height ≤ 178 cm, weight ≥ 91 kg and level of office DBP ≥ 80 mm Hg. The presence of at least two of these predictors allows to suppose necessity to start antihypertensive therapy in young patients with ISH.

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