MASKED HYPERTENSION IN YOUNG PERSONS: PREVALENCE, SIGNIFICANCE OF CARDIOVASCULAR RISK FACTORS AND PROGNOSIS BY GENDER DIFFERENCES

Aim. To evaluate the prevalence of masked arterial hypertension (MAH) in young persons, as the prevalence and significance of cardiovascular risk factors, taken gender differences.

Material and methods. A coverage screening study of 512 young persons age 19-30 y. o. was done, from institutional workers, with no specific professional harm exposures, of those 82,4% — normotonic and 17,6% have MAH. The participants underwent clinical laboratory and instrumental investigations, 30-second breath stop test.

Results. In anthropometric measures, body mass index, waist circumference, hips volume were significantly higher (p<0,005) in men and women with AHT. In men with MAH blood pressure (BP) level showed tendency to higher office systolic BP (SBP) as 130 [128;135] mmHg, than in women SBP 124 [120;130] mmHg and normotonics SBP 110 [110;120] mmHg. In men with MAH there were cardiovascular risk factors more common — smoking, dyslipidemia 6 times more prevalent than in women with MAH. The fact of inheritance predominated in MAH men (85%) comparing to MAH women (65%). In MAH the level of physical activity comparing to normotonics was 2 times lower. Men with MAH used to add table salt to their meals (57%) and ate sausages (61%), as took alcohol beverages.

Conclusion. The prevalence of MAH among young males is 9,6% and 8% in young females. In young persons with MAH comparing to normotonics, cardiovascular risk factors are found more commonly, as food-related behavior disorders and target organ damage. Thirty-year risk of atherosclerotic CVD in young men with MAH was >6 times and in women >5 times higher than in normotonics of the same age.

1. Maroszynska-Dmoch EM, Wozakowska-Kaplon B. Coronary artery disease in young adults: clinical and angiographic characterization. A single centre study. Polish Heart Journal. 2015;1-17.

2. Battistoni A, Canichella F, Pignatelli G et al. Hypertension in Young People: Epidemiology, Diagnostic Assessment and Therapeutic Approach. Нigh Blood Press Cardiovasc Prev. 2015;22(4):381-8.

3. Chazova IE, Zhernakova JuV, Oshhepkova EV et al. Prevalence of cardiovascular diseases risk factors in the Russian population of arterial hypertension patients. Kardiologiia. 2014;54(10):4-12. Russian (Чазова И.Е., Жернакова Ю.В., Ощепкова Е.В. и др. Распространенность факторов риска развития сердечно-сосудистых заболеваний в российской популяции больных артериальной гипертонией. Кардиология. 2014;54(10):4-12).

4. Sundstrom J, Neovius M, Tynelius P et al. Association of blood pressure in late adolescence with subsequent mortality: cohort study of Swedish male conscripts. BMJ. 2011;342:d643.

5. Reddy VS, Jacob GP, Ballala K et al. A study on the prevalence of hypertension among young adults in a coastal district of Karnataka, South India. International J. of Healthcare and Biomedical Research. 2015;3(3):32-39.

6. 2013 ESH/ESC Guidelines for the management of arterial hypertension. Russ J Cardiol. 2014; 1(105):7-94. Russian (Рекомендации по лечению артериальной гипертонии. ESH/ESC 2013. Российский кардиологический журнал 2014; 1(105):7-94).

7. Lyamina NP, Lyamina SV, Senchihin VN et al. Functional test on latent arterial hypertension detection in young adults. Kardiologiia. 2011;51(4):28-30. Russian (Лямина Н.П., Лямина С.В., Сенчихин В.Н. и др. Функциональная проба для выявления латентной артериальной гипертензии у лиц молодого возраста. Кардиология. 2011;51(4):28-30).

8. Lyamina NP, Smit ML, Nalivaeva AV et al. Prognostic value of 30-sec breath hold test in diagnostics of masked arterial hypertension in young adults. 2015;9:63-67. Russian (Лямина Н.П., Смит М.Л., Наливаева А.В. и др. Прогностическая ценность теста 30-секундной задержки дыхания в диагностике маскированной артериальной гипертензии у лиц молодого возраста. Фарматека. 2015;9:63-67).

9. Muntner P, Lewis CE, Diaz K et al. Racial differences in abnormal ambulatory blood pressure monitoring measures: Results from the Coronary Artery Risk Development in Young Adults (CARDIA) study. J. Hypertens. 2015;28(5):640-648.

10. Fagard RH, Cornelissen VA. Incidence of cardiovascular events in white-coat, masked and sustained hypertension vs. true normotension: a meta-analysis. J. Hypertens. 2007;25:2193–2198.

11. Ohkubo T, Kikuya M, Metoki H et al. Prognosis of «masked» hypertension and «white-coat» hypertension detected by 24-h ambulatory blood pressure monitoring 10-year follow-up from the Ohasama study. J. Am Coll Cardiolgy. 2005;46(3):508–15.

12. Lyamina NP, Smith ML, Lyamina SV et al. Pressor response to 30-s breathhold: a predictor of masked hypertension. J. Blood Press. 2012;21(6):372-6.

13. Michikawa T, Nishiwaki Y, Okamura T et al. The taste of salt measured by a simple test and blood pressure in Japanese women and men. Hypertension Research. 2009;32:399–403.

14. Dimitris P, Papadopoulos MD, Thomas K et al. Masked Hypertension Definition, Impact, Outcomes: A Critical Review. The Journal of Clinical Hypertension. 2007;9(12):956–963.

15. 2013 ACC/AHA guideline on the assessment of cardiovascular risk: А report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Goff DC, Lloyd-Jones DM, Bennett G et al. Circulation. 2014;129:49р.

16. http://tools.acc.org/LDL/ascvd_risk_estimator/index.html