In young patients with first-diagnosed, never-treated systolic hypertension, hypertension-mediated organ damage was present in 50%, with arterial stiffness being the predominant form.
Observational (n=220)
Half of young patients with newly diagnosed, untreated systolic hypertension already exhibit hypertension-mediated organ damage, highlighting a high-risk population that may benefit from early intervention.
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: ](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".
Benas et al. (Mon,) conducted a observational in First-diagnosed and never-treated systolic arterial hypertension (n=220). In young patients with first-diagnosed, never-treated systolic hypertension, hypertension-mediated organ damage was present in 50%, with arterial stiffness being the predominant form.
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