DIFFERENCIAL HEMODYNAMIC CHARACTERISTICS OF TRUE SYSTOLIC HYPERTENSION AND SPURIUS HYPERTENSION IN THE YOUTH

Abstract

Objective: In adolescents, isolated systolic hypertension (ISHT) could be associated with normal central blood pressure (cBP). This is called spurious hypertension (Sp-HT), typically occurs more in young males, and does not lead to organ damage compared to true ISHT (t-ISHT. Recently, the possibility to measure non-invasively cBP seems to be a tool able to discriminate Sp-HT from t-ISHT. Design and method: To evaluate in ISHT youths the ability of cBP to discriminate both diagnosis, t-ISHT and Sp-HT and to analyze hemodynamic and arterial stiffness parameters in both group of patients (n = 58) Methods: From 75 young subjects, no receiving antihypertensive drugs, 58 (25±4 years, 32 male) of them were identified having ISHT by 24hs ABPM. Afterwards, cBP was evaluated through a validated Mobil-O-Graph device. vs intraarterial cBP measurements, performed by our group. By this way, 28 of them were considered having t-ISHT and the 30 remaining having Sp-HT. In all of them, left ventricular mass index (LVMI, Echocardiography), Cardiac Index (CI), Pulse Wave Velocity (PWV) and microalbuminuria (mAlb) were recorded. Results: As Shown in Table 1, in t-ISHT, cBP, Heart Rate (HR), mAlb and CI were higher, compared to subjects with Sp-HT. The remaining parameters evaluated failed to show any statistical difference. Conclusions: In this cohort of youths, cBP was able to discriminate ISHT from Sp-HT. In addition, t-HT youths showed a hyperkinetic cardiac behavior (high Heart Rate and CI) and early target organ damage (increased LVMI and mAlb), thus suggesting and increased cardiovascular risk in these t-HT patients.