Blood pressure variability parameters and the risk of developing hypertension in healthy young males: 5-year follow-up study

Abstract

Purpose: Few prospective studies have evaluated increase Blood Pressure Variability (BPV) as a risk factor for onset hypertension in young populations. We conducted a prospective cohort study to examine the relationship of BPV to the onset of hypertension in healthy young males depending on family hypertensive anamnesis. Methods: Apparently healthy males aged 18-35 (n=366) without prevalent hypertension at baseline were enrolled in 2003-2005 years. All subjects took an annual medical checkup including Blood Pressure (BP) measurement, Ambulatory 24 hour Blood Pressure Monitoring (ABPM) and veloergometry - at baseline only; medical interview until 2010. The participants were categorized into 2 groups according to family anamnesis of hypertension (1st – positive family anamnesis, 2nd – negative one). Incident hypertension was defined as newly detected BP ≥140/90 mmHg and/or initiation of antihypertensive drugs. The incident hypertension was analyzed in each group. Results: During a median follow-up time of 4.6 years, there were 77 cases (21.0%) of incident hypertension. The incident hypertension rate of the 1st group was significantly higher than of the 2nd group (36.4% vs. 7.3%). The patients of the 1st group with incident hypertension in 5-year follow up had significant increased diastolic BP in veloergometry in comparison with men remained normotension. The range of morning systolic BP surge in ABPM was also higher (38.3±8.9 mmHg vs. 51.1±10.1 mmHg, p=0.039). In the 2nd group significant difference for these parameters was not revealed. The relative risks (RR) (95% confidence interval) adjusted for body mass index, excess salt intake, smoking status, and alcohol intake for incident hypertension in the 1st group in morning systolic BP surge by ABPM ≥50 mmHg was 1.43 (1.29–1.59); in the range diastolic BP in veloergometry >0% – 1.56 (1.29–1.59). Conclusions: Even if BP was within normal range, some parameters of blood pressure variability (systolic blood pressure morning surge in ABPM and elevated diastolic blood pressure in veloergometry) was a predictor of future hypertension in a healthy young-aged male population with positive family hypertensive anamnesis.