Cardiovascular Phenotype of Elevated Blood Pressure Differs Markedly Between Young Males and Females: The Enigma Study

Autor:	Nardin C; Department of Medicine-DIMED, University of Padova, Italy; Division of Experimental Medicine and Immunotherapeutics, University of Cambridge, United Kingdom, Maki-Petaja KM; Division of Experimental Medicine and Immunotherapeutics, University of Cambridge, United Kingdom, Miles KL; Division of Experimental Medicine and Immunotherapeutics, University of Cambridge, United Kingdom, Yasmin; Division of Experimental Medicine and Immunotherapeutics, University of Cambridge, United Kingdom, McDonnell BJ; Cardiff School of Health Sciences, Cardiff Metropolitan University, United Kingdom, Cockcroft JR; Cardiff School of Health Sciences, Cardiff Metropolitan University, United Kingdom, Wilkinson IB; Division of Experimental Medicine and Immunotherapeutics, University of Cambridge, United Kingdom, McEniery CM; Division of Experimental Medicine and Immunotherapeutics, University of Cambridge, United Kingdom
Jazyk:	angličtina
Zdroj:	Hypertension (Dallas, Tex. : 1979) [Hypertension] 2018 Dec; Vol. 72 (6), pp. 1277-1284. Date of Electronic Publication: 2018 Oct 15.
DOI:	10.1161/HYPERTENSIONAHA.118.11975
Abstrakt:	Blood pressure (BP) in young adults predicts BP in later life. We aimed to identify metabolic, hemodynamic, and autonomic characteristics associated with raised BP in young adults and whether these differ between males and females. Three thousand one hundred forty-five healthy subjects, aged 18 to 40 years, were grouped according to sex and BP category following the recent reclassification of BP as part of American Heart Association/American College of Cardiology 2017 guidelines. All individuals undertook a lifestyle and medical history questionnaire and detailed metabolic, hemodynamic, and autonomic assessments. Stage 1 hypertension and normal BP were the most common BP phenotypes in males (29%) and females (68%), respectively. In both sexes, cardiac output was positively associated with increasing BP category (P<0.001 for both). Similar positive trends were observed for heart rate and stroke volume in males (P<0.001 for both) and heart rate in females (P<0.001). Unlike in males, peripheral vascular resistance, aortic pulse wave velocity, and augmentation index were significantly increased in hypertensive females (P<0.001 for all) compared with the other BP categories. Most heart rate variability indices decreased across the BP categories, particularly in males. In young adults, metabolic and hemodynamic abnormalities associated with hypertension are already present at the elevated BP stage and the overall phenotype differed markedly between sexes. Whereas a cardiac phenotype was associated with elevated BP and hypertension in males, a vascular phenotype, characterized by elevated peripheral vascular resistance, aortic pulse wave velocity, and augmentation index, was dominant in females. (© 2018 The Authors. Hypertension is published on behalf of the American Heart Association, Inc., by Wolters Kluwer Health, Inc. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution, and reproduction in any medium, provided that the original work is properly cited.)
Databáze:	MEDLINE
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