Title:Hypertension-Mediated Organ Damage In Young Patients With First-Diagnosed And Never Treated Systolic Hypertension
Volume: 21
Issue: 3
Author(s): Dimitris Benas, Helen Triantafyllidi*, Dionyssia Birmpa, Anastasia Fambri, Antonios Schoinas, Ioannis Thymis, Gavriela Kostelli and Ignatios Ikonomidis
Affiliation:
- 2nd Department of Cardiology, Medical School, National and Kapodistrian University of Athens, ATTIKON Hospital,
Athens, Greece
Keywords:
First diagnosed essential hypertension, young hypertensive patients, cardiovascular risk factors, hypertensionmediated organ damage, pulse wave velocity, left ventricular hypertrophy.
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".
