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Current Vascular Pharmacology

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ISSN (Print): 1570-1611
ISSN (Online): 1875-6212

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Research Article

Hypertension-Mediated Organ Damage In Young Patients With First-Diagnosed And Never Treated Systolic Hypertension

Author(s): Dimitris Benas, Helen Triantafyllidi*, Dionyssia Birmpa, Anastasia Fambri, Antonios Schoinas, Ioannis Thymis, Gavriela Kostelli and Ignatios Ikonomidis

Volume 21, Issue 3, 2023

Published on: 31 May, 2023

Page: [197 - 204] Pages: 8

DOI: 10.2174/1570161121666230531153431

Price: $65

Abstract

Objective: Early onset of untreated arterial hypertension is associated with an increased risk for cardiovascular (CV) diseases. The evaluation of hypertension-mediated organ damage (HMOD) helps estimating CV risk. We investigated the incidence of HMOD in young first, diagnosed and nevertreated patients with systolic arterial hypertension (SH) to identify high CV-risk patients based on the presence of HMOD.

Methods: CV risk factors [smoking, obesity (body mass index, BMI)], hyperlipidemia and 5 HMODs [arterial stiffness (pulse wave velocity, PWV), left ventricular diastolic dysfunction [(DD (E/Ea)], cardiac hypertrophy (left ventricular mass index, LVMI), coronary artery microcirculation (CFR), and carotid intima-media thickness (cIMT)] were evaluated before treatment initiation in 220 patients, aged ≤50 years [median (interquartile range, IQR) age=43(38-47)], with SH diagnosed by ambulatory blood pressure monitoring (24-h ABPM).

Results: Smoking (40%) and obesity [median (IQR) BMI=30(26-32) kg/m2](40%) were found in young hypertensives. HMOD was found in 50% of hypertensives (10% had ≥2 HMOD). The most prevalent HMODs were increased by cIMT (32%) and PWV (19%), LVH (9%), impaired CFR (6%) and DD (1%). Only PWV (beta=0.27, p<0.001) and LVMI (beta=0.41, p<0.001) were associated with systolic BP burden. In a subgroup analysis, patients with ≥2 HMOD were older with increased office BP and 24- h ABPM, impaired lipid profile, and increased LVMI, PWV, CFR, and cIMT compared with the rest of the hypertensives.

Conclusion: The presence of ≥2 of the studied HMOD (PWV, LVMI, cIMT, E/Ea, CFR) in young hypertensives characterizes a “high-risk population”. Arterial stiffness represents the predominant HMOD and in the whole population and "high-risk population".

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[1]
Ezzati M, Lopez AD, Rodgers A, Vander Hoorn S, Murray CJL. Selected major risk factors and global and regional burden of disease. Lancet 2002; 360(9343): 1347-60.
[http://dx.doi.org/10.1016/S0140-6736(02)11403-6] [PMID: 12423980]
[2]
Lewington S, Clarke R, Qizilbash N, Peto R, Collins R. Age-specific relevance of usual blood pressure to vascular mortality: A meta-analysis of individual data for one million adults in 61 prospective studies. Lancet 2002; 360(9349): 1903-13.
[http://dx.doi.org/10.1016/S0140-6736(02)11911-8] [PMID: 12493255]
[3]
Mancia G, Facchetti R, Bombelli M, et al. Relationship of office, home, and ambulatory blood pressure to blood glucose and lipid variables in the PAMELA population. Hypertension 2005; 45(6): 1072-7.
[http://dx.doi.org/10.1161/01.HYP.0000165672.69176.ed] [PMID: 15867138]
[4]
Berry JD, Dyer A, Cai X, et al. Lifetime risks of cardiovascular disease. N Engl J Med 2012; 366(4): 321-9.
[http://dx.doi.org/10.1056/NEJMoa1012848] [PMID: 22276822]
[5]
De Venecia T, Lu M, Figueredo VM. Hypertension in young adults. Postgrad Med 2016; 128(2): 201-7.
[http://dx.doi.org/10.1080/00325481.2016.1147927] [PMID: 26821528]
[6]
Muntner P, He J, Cutler JA, Wildman RP, Whelton PK. Trends in blood pressure among children and adolescents. JAMA 2004; 291(17): 2107-13.
[http://dx.doi.org/10.1001/jama.291.17.2107] [PMID: 15126439]
[7]
Torrance B, McGuire KA, Lewanczuk R, McGavock J. Overweight, physical activity and high blood pressure in children: A review of the literature. Vasc Health Risk Manag 2007; 3(1): 139-49.
[PMID: 17583184]
[8]
Messner B, Bernhard D. Smoking and cardiovascular disease: mechanisms of endothelial dysfunction and early atherogenesis. Arterioscler Thromb Vasc Biol 2014; 34(3): 509-15.
[http://dx.doi.org/10.1161/ATVBAHA.113.300156] [PMID: 24554606]
[9]
Virdis A, Giannarelli C, Fritsch Neves M, Taddei S, Ghiadoni L. Cigarette smoking and hypertension. Curr Pharm Des 2010; 16(23): 2518-25.
[http://dx.doi.org/10.2174/138161210792062920] [PMID: 20550499]
[10]
Soneji S, Barrington-Trimis JL, Wills TA, et al. Association between initial use of e-cigarettes and subsequent cigarette smoking among adolescents and young adults. JAMA Pediatr 2017; 171(8): 788-97.
[http://dx.doi.org/10.1001/jamapediatrics.2017.1488] [PMID: 28654986]
[11]
Williams B, Mancia G, Spiering W, et al. 2018 Practice Guidelines for the management of arterial hypertension of the European Society of Hypertension and the European Society of Cardiology: ESH/ESC Task Force for the Management of Arterial Hypertension. J Hypertens 2018; 36(12): 2284-309.
[http://dx.doi.org/10.1097/HJH.0000000000001961] [PMID: 30379783]
[12]
Piskorz D. Hypertensive mediated organ damage and hypertension management. How to assess beneficial effects of antihypertensive treatments? High Blood Press Cardiovasc Prev 2020; 27(1): 9-17.
[http://dx.doi.org/10.1007/s40292-020-00361-6] [PMID: 31975151]
[13]
Triantafyllidi H, Trivilou P, Ikonomidis I, et al. Is arterial hypertension control enough to improve aortic stiffness in untreated patients with hypertension? a 3-year follow-up study. Angiology 2015; 66(8): 759-65.
[http://dx.doi.org/10.1177/0003319714552811] [PMID: 25274527]
[14]
Devereux R, Reichek N. Echocardiographic assessment of left ventricular mass in man. Circulation 1977; 55: 613-8.
[http://dx.doi.org/10.1161/01.CIR.55.4.613] [PMID: 138494]
[15]
Battistoni A, Canichella F, Pignatelli G, Ferrucci A, Tocci G, Volpe M. Hypertension in young people: Epidemiology, diagnostic assessment and therapeutic approach. High Blood Press Cardiovasc Prev 2015; 22(4): 381-8.
[http://dx.doi.org/10.1007/s40292-015-0114-3] [PMID: 26153401]
[16]
Assadi F. The growing epidemic of hypertension among children and adolescents: A challenging road ahead. Pediatr Cardiol 2012; 33(7): 1013-20.
[http://dx.doi.org/10.1007/s00246-012-0333-5] [PMID: 22565200]
[17]
Kollias A, Pantsiotou K, Karpettas N, Roussias L, Stergiou GS. Tracking of blood pressure from childhood to adolescence in a Greek cohort. Eur J Public Health 2012; 22(3): 389-93.
[http://dx.doi.org/10.1093/eurpub/ckr082] [PMID: 21705785]
[18]
Amato M, Frigerio B, Castelnuovo S, et al. Effects of smoking regular or light cigarettes on brachial artery flow-mediated dilation. Atherosclerosis 2013; 228(1): 153-60.
[http://dx.doi.org/10.1016/j.atherosclerosis.2013.02.037] [PMID: 23528831]
[19]
Athyros VG, Katsiki N, Doumas M, Karagiannis A, Mikhailidis DP. Effect of tobacco smoking and smoking cessation on plasma lipoproteins and associated major cardiovascular risk factors: A narrative review. Curr Med Res Opin 2013; 29(10): 1263-74.
[http://dx.doi.org/10.1185/03007995.2013.827566] [PMID: 23879722]
[20]
Omvik P. How smoking affects blood pressure. Blood Press 1996; 5(2): 71-7.
[http://dx.doi.org/10.3109/08037059609062111] [PMID: 9162447]
[21]
Cryer PE, Haymond MW, Santiago JV, Shah SD. Norepinephrine and epinephrine release and adrenergic mediation of smoking-associated hemodynamic and metabolic events. N Engl J Med 1976; 295(11): 573-7.
[http://dx.doi.org/10.1056/NEJM197609092951101] [PMID: 950972]
[22]
Rodriguez-Portelles A, Rodriguez-Leyva D. Endothelial and left ventricular diastolic function in young adults exposed to tobacco. Can J Physiol Pharmacol 2019; 97(10): 1006-11.
[http://dx.doi.org/10.1139/cjpp-2019-0187] [PMID: 31269406]
[23]
Alshehri AM, Azoz AM, Shaheen HA, Farrag YA, Khalifa MAA, Youssef A. Acute effects of cigarette smoking on the cardiac diastolic functions. J Saudi Heart Assoc 2013; 25(3): 173-9.
[http://dx.doi.org/10.1016/j.jsha.2013.03.003] [PMID: 24174857]
[24]
Gidding SS, Liu K, Colangelo LA, et al. Longitudinal determinants of left ventricular mass and geometry: The Coronary Artery Risk Development in Young Adults (CARDIA) Study. Circ Cardiovasc Imaging 2013; 6(5): 769-75.
[http://dx.doi.org/10.1161/CIRCIMAGING.112.000450] [PMID: 23922005]
[25]
Andrade H, Pires A, Noronha N, et al. Importance of ambulatory blood pressure monitoring in the diagnosis and prognosis of pediatric hypertension. Revista Portuguesa de Cardiologia 2018; 37(9): 783-9.
[http://dx.doi.org/10.1016/j.repce.2018.08.005] [PMID: 29871785]
[26]
Netti A, Borrelli S, Peruzzu N, et al. Role of Ambulatory Blood Pressure Monitoring (ABPM) in chronic kidney patients: A review. G Ital Nefrol 2019; 36(3): 2019.
[PMID: 31250998]
[27]
Strandberg TE, Pitkala K. What is the most important component of blood pressure: Systolic, diastolic or pulse pressure? Curr Opin Nephrol Hypertens 2003; 12(3): 293-7.
[http://dx.doi.org/10.1097/00041552-200305000-00011] [PMID: 12698068]
[28]
O’Rourke MF, Adji A. Guidelines on guidelines. J Hypertens 2013; 31(4): 649-54.
[http://dx.doi.org/10.1097/HJH.0b013e32835d8230] [PMID: 23412425]
[29]
Kanegae H, Oikawa T, Okawara Y, Hoshide S, Kario K. Which blood pressure measurement, systolic or diastolic, better predicts future hypertension in normotensive young adults? J Clin Hypertens 2017; 19(6): 603-10.
[http://dx.doi.org/10.1111/jch.13015] [PMID: 28444926]
[30]
Grebla RC, Rodriguez CJ, Borrell LN, Pickering TG. Prevalence and determinants of isolated systolic hypertension among young adults: The 1999–2004 US National Health And Nutrition Examination Survey. J Hypertens 2010; 28(1): 15-23.
[http://dx.doi.org/10.1097/HJH.0b013e328331b7ff] [PMID: 19730124]
[31]
Chobanian AV, Bakris GL, Black HR, et al. Seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure. Hypertension 2003; 42(6): 1206-52.
[http://dx.doi.org/10.1161/01.HYP.0000107251.49515.c2] [PMID: 14656957]
[32]
Jones NR, McCormack T, Constanti M, McManus RJ. Diagnosis and management of hypertension in adults: NICE guideline update 2019. Br J Gen Pract 2020; 70(691): 90-1.
[http://dx.doi.org/10.3399/bjgp20X708053] [PMID: 32001477]
[33]
Pikula A, Beiser AS, DeCarli C, et al. Multiple biomarkers and risk of clinical and subclinical vascular brain injury: The Framingham Off-spring Study. Circulation 2012; 125(17): 2100-7.
[http://dx.doi.org/10.1161/CIRCULATIONAHA.110.989145] [PMID: 22456473]
[34]
Romero JR, Preis SR, Beiser AS, et al. Lipoprotein phospholipase A2 and cerebral microbleeds in the Framingham Heart Study. Stroke 2012; 43(11): 3091-4.
[http://dx.doi.org/10.1161/STROKEAHA.112.656744] [PMID: 22961963]
[35]
Suvila K, Niiranen TJ. Interrelations between high blood pressure, organ damage, and cardiovascular disease: No more room for doubt. Hypertension 2022; 79(3): 516-7.
[http://dx.doi.org/10.1161/HYPERTENSIONAHA.121.18786] [PMID: 35138870]
[36]
Triantafyllidi H, Benas D, Schoinas A, et al. Hypertension‐mediated organ damage regression associates with blood pressure variability improvement three years after successful treatment initiation in essential hypertension. J Clin Hypertens 2021; 23(6): 1150-8.
[http://dx.doi.org/10.1111/jch.14209] [PMID: 33554428]
[37]
Vasan RS, Song RJ, Xanthakis V, et al. Hypertension-mediated organ damage: Prevalence, correlates, and prognosis in the community. Hypertension 2022; 79(3): 505-15.
[http://dx.doi.org/10.1161/HYPERTENSIONAHA.121.18502] [PMID: 35138872]
[38]
Polak JF, Pencina MJ, Meisner A, et al. Associations of carotid artery intima-media thickness (IMT) with risk factors and prevalent cardiovascular disease: Comparison of mean common carotid artery IMT with maximum internal carotid artery IMT. J Ultrasound Med 2010; 29(12): 1759-68.
[http://dx.doi.org/10.7863/jum.2010.29.12.1759] [PMID: 21098848]
[39]
Schillaci G, Battista F, Pucci G. A review of the role of electrocardiography in the diagnosis of left ventricular hypertrophy in hypertension. J Electrocardiol 2012; 45(6): 617-23.
[http://dx.doi.org/10.1016/j.jelectrocard.2012.08.051] [PMID: 23022303]

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