Isolated systolic hypertension in young adults and their connection to ambulatory measurement of blood pressure in a third-level hospital of the Buenos Aires province
Keywords:
young adult, isolated systolic hypertension, clinical epidemiology, ambulatory blood pressure monitoringAbstract
Introduction: the definition of isolated systolic hypertension (ISH) accepted by clinical guidelines sets a systolic blood pressure (SBP) cutoff point at ≤140-90 mmHg, with diastolic blood pressure (DBP) values below 90 mmHg. This phenotype is the most prevalent type of arterial hypertension (AH) in young people. The
prognosis of isolated systolic hypertension (ISH) varies depending on different pathophysiological mechanisms. Some associations of this phenotype with ambulatory blood pressure monotoring (ABPM) have been described, but its association with nocturnal
BP values has not been emphasized. To our knowledge, there are no epidemiological data on young patients in Latin America establishing this relationship.
Objective: to describe the characteristics of ISH in young patients consulting at third-level hospitals in the Buenos Aires province, and to analyze the relationship with different ABPM phenotypes.
Materials and methods: adults between 16 and 40 years of age without antihypertensive treatment were evaluated in a cross-sectional study, derived for an ABMP to a third-level hospital, from 1 July 2013 to 31 August 2022. Each individual underwent an initial interview, BP measurements, and ABPM
evaluation.
Results: a total of 395 individuals were evaluated (69% women, 29±6.5years of age). The prevalence according to office phenotypes was: normotensives (77%), ISH (6%), and HT (17%). Among those with ISH, 29.2 % registered white-coat hypertension (WCT). The Kappa agreement was K=31% for office phenotypes versus ABMP. Of those with ISH, 37% registered at least one
elevated period (either diurnal or nocturnal), and 12.5% had only the nocturnal period elevated.
Discussion: lower prevalences of ISH were found compared to those described in the literature. Systolic-diastolic hypertension remains the predominant subtype of hypertension even in young people in Argentina, in contrast to reports from other countries.
The use of ABMP is important for accurately describing the phenotype and assessing long-term prognosis.
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