Isolated systolic hypertension in young adults and its relationship with ambulatory blood pressure measurements

Espeche W, Minetto J*, Stavile N, Cerri G, C Leiva Sisnieguez, D Olano, JI Perez Duhalde and Salazar MR

Introduction: The definition of Isolated Systolic Hypertension (ISH) is accepted by guidelines, which adopt a blood pressure (BP) cutoff point of 140/90 mmHg, with elevated Systolic Blood Pressure (SBP) and normal diastolic blood pressure (DBP) in the clinic. This phenotype represents the most common form of Hypertension (HT) in young individuals.

The prognosis of ISH differs according to various explanatory mechanisms. Some associations of this phenotype with Ambulatory Blood Pressure Monitoring (ABPM) have been described, but little emphasis has been placed on its association with nocturnal BP values. To the best of our knowledge, there is no epidemiological data on young patients establishing this relationship in Latin America.

Objective: To describe the characteristics of ISH in our population of young patients and analyze its relationship with different ABPM phenotypes.

Materials and methods: Consecutive adult individuals between 16 and 40 years of age, without antihypertensive treatment, were evaluated in a cross-sectional study. They were referred for ABPM to a tertiary hospital between July 2013 and August 2022.

Each individual underwent an initial interview, three BP measurements using current standards with OMROM HEM 705 devices, and subsequent ABPM with Spacelabs 90207.

A general description of the sample was provided, and an analysis was conducted based on different patient phenotypes determined by clinic BP measurements in relation to various ABPM phenotypes.

Results: A total of 395 individuals (69% women, 29 ± 6.5 years) were finally evaluated. The frequencies according to clinic phenotypes were as follows: Normotensive = 77%, ISH = 6%, HT = 17%.

Among the ISH group, 29.2% had white coat hypertension (WCH). The Kappa agreement was 31% for clinic phenotypes vs. ABPM. Among ISH patients, 37% had at least one elevated period (daytime or nighttime), and 12.5% had elevated BP only during the nighttime.

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Published on: May 29, 2024 Pages: 1-6

Full Text PDF Full Text HTML DOI: 10.17352/ach.000034
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