Hypertension In Young People Research Articles

Salt-sensitive hypertension in young people: How can we predict the risk of hypertensive heart disease?

Salt-sensitive hypertension in young people: How can we predict the risk of hypertensive heart disease?

Stress coping strategies — novel markers in the diagnosis of masked hypertension in young people

Aim. To establish the prevalence and markers of masked hypertension (HTN) in apparently healthy young people.Material and methods. The cross-sectional study included young people (20-30 years old) with health group I or II, with clinical blood pressure (BP) <140/90 mm Hg. All participants underwent 24-hour blood pressure monitoring, assessment of traditional cardiovascular risk factors and ways of coping with stress.Results. A total of 347 participants were included (mean age, 22 (21-23) years; male, 101 (29,1%)). After 24-hour blood pressure monitoring, masked HTN was detected in 46 (13,3%) participants. Multivariate analysis found following markers of masked HTN: office systolic blood pressure (adjusted odds ratio (AOR) 1,109; p<0,001), resting heart rate (AOR 1,051; p=0,021), body mass index ≥25 kg/m2 (AOR 2,345; p=0,039), two models of coping with stress — distancing (AOR 1,071; p=0,001) and self-control (AOR 0,951; p=0,012). These parameters are included in the formula for calculating the masked HTN probability.Conclusion. Masked HTN occurs in 13,3% of apparently healthy young people. Associations of masked HTN with strategies for coping with stress have been established, which allows them to be regarded as novel markers of masked HTN. The method described in the article makes it possible to identify masked HTN with a high probability in young people.

EVA syndrome and hypertension in young people according to the work of the University Health Center of the StSMU

EVA syndrome and hypertension in young people according to the work of the University Health Center of the StSMU

S-43-7: HYPERTENSION IN ADOLESCENTS AND YOUNG PEOPLE: OPPORTUNITIES FOR INTERVENTION IN SOUTH AFRICA

Hypertension in adolescents and young people is a rising concern across the world. In South Africa the cardiovascular epidemic is simultaneous to the HIV and TB epidemics. Sub-Saharan Africa has a large proportion of young people compared to many developed regions but poor access to healthcare. This presentation will discuss the epidemiology of hypertension in young people, the causes of hypertension and the approach to diagnosis and causes. There will be discussion about how this age group is the optimal age in which to introduce screening and lifestyle changes and how to address this age group.

Hypertension in the Young Adults

Background: Hypertension is a non-communicable disease which is an important risk factor for cardiovascular diseases. The prevalence has been documented to be highest in Africa where 46% of the world’s population with hypertension reportedly resides. There is a global concern that hypertension in teenagers and young adults are on the increase and cases are not detected because of inadequate screening in this age group. Objective: To determine the prevalence of hypertension among undergraduates in Rivers State. Materials and Methods: This was a cross-sectional study conducted in Rivers State. The subjects were recruited from University of Port Harcourt, Rivers State University and Ignatius Ajuru University which are the three major tertiary institutions in Rivers State and their ages ranged between 16 and 35 years. Data collected were analyzed using Statistical Package for Social Sciences. Results: A total of 1096 respondents were recruited for the study, there were 570 (52%) males and 526 (48%) females. Sixteen (1.5%) of them were married while 1080 (98.5%) were single. The prevalence of hypertension among the respondents was 21%. Adding salt to meal before eating and noodles consumption were significantly associated with hypertension. Other risk factors which included smoking, alcohol consumption, and physical inactivity, family history of hypertension and/or CVD and use of social drugs were not significantly associated with increased prevalence of hypertension. Conclusion: The prevalence of hypertension was high in this study there was a significant association between hypertension and risk factors such as salt intake and noodles consumption. Health practitioners should enlighten the public on the presence of hypertension in young people. There is also need to create awareness of hypertension even in young adults and promote early lifestyle changes.

Features of treatment of chronic brain ischemia in young patients with arterial hypertension

Actuality: Increasing the frequency of hypertension among the young population is a socially significant problem. The insidiousness of hypertension in young people is that it has the character of a disease with few symptoms. Since hypertension plays one of the main roles in the pathogenesis of chronic disorders of cerebral blood circulation, including both arterial and venous systems, the search for pathogenetically determined medicinal approaches to the elimination of cerebrovascular disorders, especially at a young age, continues. The purpose of the study: to study the effectiveness, tolerability and safety of the combination of Flego and Cognitium in young patients with chronic cerebral ischemia (CMI) on the background of hypertension. Methods: clinical-neurological, psychodiagnostic (asthenic state scale (ASS), anxiety scores according to the Spielberger-Hanin scale and Beck depression scale, Montreal scale of cognitive function assessment (MoCA)), ultrasound examination, general scale of clinical impression, statistical. Results: 52 patients (28 men and 24 women) at a young age with AMI on the background of hypertension were examined. The median age of the examined patients was (37.7 ± 4.6) years; among them, 23 patients suffered from hypertension of the 1st century. and 29 patients with hypertension of the second stage. Patients were randomly divided into two groups - the first - 23 (44.2%) patients (received only hypotensive drugs), the second - 29 (55.8%) patients (in addition to the standard hypotensive therapy received a combination of Phlego and Cognitium). Dynamic monitoring of patients after 2 months of treatment did not show significant changes in the distribution structure of objective clinical and neurological symptoms. However, positive dynamics of indicators of cognitive functions and the psychoemotional state of the subjects were observed, as well as a statistically significant decrease in the blood flow rate in the direct sinus at the end of the 2-month course using the combination of Phlego and Cognitium (decreased from 36.27±2.84 cm/s to 25.65±1.47 cm/s.). Conclusions: The introduction of the combination of Phlego and Cognitium into the treatment of young patients with arterial hypertension and chronic brain ischemia had a positive effect on the subjective state, on indicators of asthenia, emotional and cognitive state of the patients. A significant positive effect was noted in the dynamics of venous blood flow indicators (speed of blood flow in the direct sinus). Such treatment was well tolerated by patients, had few side effects and was combined with other drugs

The frequency of arterial hypertension in young people with different types of diabetes mellitus

Objective. Arterial hypertension (AH) and diabetes mellitus (DM) are frequent comorbid diseases, which are associated with a high level of disability and mortality. According to the literature hypertension occurs in 50–80% of patients with type 2 diabetes (DM2) (which constitute more than 90% of the population with type 2 diabetes), compared with 30% of patients with type 1 diabetes (DM1). Comparative studies on the frequency of AH in young patients with different types of DM in the Siberian region have not been conducted. The aim of the research work was to study the frequency of AH and associations of AH with clinical and laboratory parameters in various types of DM diagnosed before the age of 45 years.Design and methods. 174 patients with the onset of DM from 18 to 45 years old were included. They were under observation at the Research Institute of Internal and Preventive Medicine — Branch of the Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences: in 20 patients DM1 was verified (group 1), in 80 — DM2 (group 2), 20 had HNF1A-MODY (Maturity-Onset Diabetes of the Young) (group 3), 36 had GCK-MODY (group 4), 18 had LADA (“latent autoimmune diabetes in adults”) (Group 5). All patients was done a clinical examination, determination of indicators of carbohydrate metabolism and basic biochemical parameters.Results. All groups were comparable in terms of gender, age, and duration of DM. AH of 1–2 degrees in group 1 was detected in 5 patients (25,0%), in 2 — in 20 people (25,0%), in 3 — in 5 (25,0%), in 4 — in 4 (11,1%), in 5 — in 4 (22,2%), significant differences were not identified. In different types of DM the development of AH is associated with various clinical and laboratory parameters. In DM1, the development of AH has a correlation with the age of the patient, with the level of low-density lipoprotein cholesterol; in DM2 — with the duration of diabetes, the patient’s age, body mass index, glucose level, lipid spectrum and diabetic complications; with HNF1A-MODY— with diabetic complications; with GCK-MODY — with the duration of diabetes, the age of the patient, with the level of total cholesterol, with the development of nephropathy; with LADA — with indicators of carbohydrate metabolism and triglycerides.Conclusions. It is necessary to screen for the presence of AH for any type of DM in young people. It is necessary to take into account the clinical and laboratory parameters associated with the AH depending on the type of DM.

Reduced renal function in hypertension in young adults: a systematic review

Objective. The aim of the systematic review was to find an answer to the question: «does an increased blood pressure affect kidney function at young age?».Design and methods. The following key words were used to search for relevant publications: “hypertensive nephropathy”, “reduction of glomerular filtration rate in arterial hypertension” in Russian and English. We used “eLIBRARY.RU — SCIENTIFIC ELECTRONIC LIBRARY” and PubMed.gov databases. The inclusion criteria were the young age of the examined patients (from 18 to 44 years), the absence of concomitant pathology. The analysis included only publications of the last 5 years (2015-2020).Results. A total of 18 articles were selected from Russian and international databases that meet inclusion criteria.Conclusions. Based on the analysis of the literature of the last 5 years we assume that increase in blood pressure disrupts kidney function in young people. However, the current data a number of limitations. Until now, gender characteristics, risk factors for decreased renal function in hypertension in young people, and most importantly, the pathogenetic basis of renal dysfunction remain unclear.

Screening for hypertension in young people with obesity: Feasibility in the real life

Background and aimScreening for pediatric hypertension (HTN) is based on several measurements of blood pressure (BP) in different visits. We aimed to assess its feasibility in outpatient youths with overweight/obesity (OW/OB) in terms of adherence to two-repeated measurements of BP and to show the features of youths who missed the follow-up and the predictive role of clinical and/or anamnestic features on confirmed HTN. Methods and resultsSix hundred, eighty-eight youths (9–17 years) with OW/OB, consecutively recruited, underwent a first measurement of BP. Those exhibiting BP levels within the hypertensive range were invited to repeat a second measurement within 1–2 weeks. Confirmed HTN was diagnosed when BP in the hypertensive range was confirmed at the second measurement. At entry, 174 youths (25.1%) were classified as hypertensive. At the second visit, 66 youths (37.9%) were lost to follow-up. In the remaining 108 participants, HTN was confirmed in 59, so that the prevalence of confirmed HTN was 9.5% in the overall sample; it was higher in adolescents than children (15.9% vs 6.8%, P = 0.001). HTN at first visit showed the best sensitivity (100%) and a good specificity (91%) for confirmed HTN. The association of HTN at first visit plus familial HTN showed high specificity (98%) and positive predictive value of 70%. ConclusionThe high drop-out rate confirms the real difficulty to obtain a complete diagnostic follow up in the obese population. Information about family history of HTN may assist pediatricians in identifying those children who are at higher risk of confirmed HTN.

Predictors of arterial hypertension in young people with high normal blood pressure

Predictors of arterial hypertension in young people with high normal blood pressure

Age and sex differences in sleep disorders as risk factors and markers of hypertension in young people with normal body weight

Objective. To assess age and sex differences in sleep disorders as risk factors and markers of hypertension (HTN) in 18–39-year old people with normal body weight. Design and methods. We performed a cross-sectional study based on the internet survey of 18–39-year-old people with body mass index of 18–25 kg/m2 (n = 2094). The unvalidated questionnaire included 42 questions about various types of sleep disorders and sleep-associated symptoms (0 — never, 1 — rarely, 2 — from time to time, 3 — quite often, 4 — almost all the time). Results. The probability of detecting HTN in young men with normal body weight is higher than in women with similar characteristics (p < 0,001). In women, the probability of detecting HTN decreases, starting with the youngest category (18–24 years old), reaching a minimum in the age group 30–34 years old and then starts to increase. By the age of 40, the indicators for men and women become similar. Based on a multivariate analysis, the risk of HTN in young people with normal body weight is associated with both gender and age (p = 0,022). The contribution of gender to age-related changes in sleep complaints was found for snoring (p < 0,001), sleep apnea (p < 0,001), early awakenings (p = 0,002). The contribution of gender was also noted for various symptoms — daytime sleepiness, some symptoms of restless legs syndrome (RLS), anxiety, depression, leg cramps (p < 0,001) and nocturnal heartburn (p < 0,001). The contribution of age was noted for snoring (p < 0,001), sleep apnea (p < 0,001), early awakenings (p < 0,001) and for a variety of symptoms — daytime sleepiness, some symptoms of RLS, anxiety, nocturnal cough, and nocturnal choking. Conclusions. Our data can be considered when developing measures for HTN prevention, can be recommended for clinical use, as well as in subsequent clinical studies using validated questionnaires.

Вплив генотипів NFATC1 і NFATC4 на самооцінку якості життя у підлітків 16–18 років з первинною артеріальною гіпертензією

Актуальність. Дослідження, спрямовані на фенотипування варіацій генів NFATC, можуть бути перспективними для вивчення патогенезу і клінічних проявів артеріальної гіпертензії (АГ) у молодих осіб. Мета дослідження: визначення впливу варіабельності генів NFATC1 і NFATC4 на оцінки якості життя (ЯЖ) відповідно до анкети SF-36 у підлітків з первинною АГ. Матеріали та методи. Об’єкт дослідження — 84 підлітки 16–18 років, студенти медичного університету. На початку дослідження і через 2 роки, по досягненню молодими людьми віку 18 років, проводилося анкетування з використанням опитувальника SF-36. У плані клінічного обстеження використовували офісні вимірювання артеріального тиску (АТ), добовий моніторинг АТ (апарат CardioTens), інструментально-лабораторне тестування з метою виключення симптоматичної АГ, молекулярно-генетичне дослідження експресії генів NFATC1 і NFATC4 і частоти виникнення їх однонуклеотидних поліморфізмів rs7240256, rs11665469, rs754505, rs2229309. Результати. Дослідження виявило підвищену експресію названих генів, яка в 3 і 17 разів відповідно перевищувала референтні рівні. Генотип ТТ rs11665469 гена NFATC1 був асоційований з найнижчими оцінками ЯЖ життя у хворих АГ, які становили лише 75 % від ідеального рівня, за рахунок незадоволеності хворих загальним станом свого здоров’я; рівнем рольового функціонування, обумовленого фізичним станом; рівнем соціального функціонування; наявністю болю; рівнями життєвої активності та психічного здоров’я. Висновки. Встановлено асоціацію генотипу ТТ rs11665469 NFATC1 з низькою самооцінкою ЯЖ його носіїв. Вперше отримані дані свідчать про те, що генотипи rs11665469 NFATC1 впливають на самопочуття хворих молодого віку з АГ і, можливо, беруть участь у формуванні патогенезу АГ.

Isolated systolic hypertension of the young and sodium intake.

Isolated systolic hypertension is associated with higher risk of cardiovascular disease and all-cause mortality. Despite being the most common form of hypertension in the elderly, it is also detectable among young and middle-aged subjects. Dietary salt (sodium chloride) intake is an important determinant of blood pressure, and high salt intake is associated with greater risk of hypertension and cardiovascular events. In most countries, habitual salt intake at all age categories largely exceeds the international recommendations. Excess salt intake, often interacting with overweight and insulin resistance, may contribute to the development and maintenance of isolated systolic hypertension in young individuals by causing endothelial dysfunction and promoting arterial stiffness through a number of mechanisms, namely increase in the renin-angiotensin-aldosterone system activity, sympathetic tone and salt-sensitivity. This short review focused on the epidemiological and clinical evidence, the mechanistic pathways and the cluster of pathophysiological factors whereby excess salt intake may favor the development and maintenance of isolated systolic hypertension in young people.

Prevalence of hypertension among young men: fifteen-year trends

Objective. The aim of the study was to assess the changes in the prevalence of hypertension (HTN) among young men according to two screenings of independent samples of an open urban population.Design and methods. The study is based on two cross-sectional studies, over a fifteen year range, among males in the Central Administrative District of Tyumen. Representative samples were formed according to a single protocol from electoral lists among men 25–64 years old by the method of “random numbers” — 1000 people each (250 people each in four decades of life), the response was 79,5 % and 85,0 %, respectively, in the first and second screening. As part of cardiac screenings, the prevalence of HTN, mean values and percentile distribution for systolic and diastolic blood pressure (SBP, DBP) were determined in two groups of young age 25–34 and 35–44 years.Results. Young men of an open population of a moderately urbanized city of Western Siberia have high blood pressure (BP) levels with a significant increase in average levels and percentile distribution of SBP and DBP in the age range from the third to the fourth decade of life. According to the results of two cross-sectional studies in the range of fifteen years, we found a tendency towards a decrease in SBP and the prevalence of HTN in men in the third decade of life in an open population of a moderately urbanized city of Western Siberia. At the same time, the levels of SBP, DBP and the prevalence of HTN in the fourth decade of life remain stable.Conclusions. We found high levels of BP and the prevalence of HTN among young men in a medium-urbanized city of Western Siberia and a positive fifteen-year dynamics in reduced prevalence of HTN in young people. The latter is a favorable factor and opens up opportunities for targeted impact on other conventional and non-conventional cardiovascular risk factors in this age group.

Sleep disorders — risk factors and hypertension markers in young people with normal body weight

Aim. To assess the relationship between different types of sleep disorders, sleep-related symptoms and hypertension (HTN).Material and methods. This cross-sectional study based on the online survey of persons aged 18-39 years with a body mass index of 18-25 kg/m2.Results. According to the results, the HTN risk in persons aged 18-39 years with normal body mass index increases 2 or more times in the presence of various types of sleep disorders and related symptoms. The prevalence of HTGN depends on the patient's phenotype, i.e. from a combination of different types of sleep disorders and sleep-related symptoms.Conclusion. Given the widespread prevalence of various sleep disorders, as well as the relationship between sleep disorders and hypertension in young people, it is necessary to develop preventive measures aimed at reducing the HTN risk by restoring healthy sleep. We also suggest that various sleep disorders may be the primary link in the development of essential HTN.

The D allele of angiotensin-converting enzyme gene is associated with a worse autonomic heart control in community-based older adults.

The relationship between the Renin-Angiotensin-Aldosterone System (RAAS) and modulation of the Autonomic Nervous System (ANS) is reported as complex and bidirectional. Thus, the present study aimed to compare autonomous heart control, through symbolic analysis parameters, in the older adults carrying different ACE I/D gene polymorphisms (rs4646994). Two hundred four older adults comprised the study population and were grouped according to the ACE I/D gene polymorphism: II+ID genotype and DD genotype. Successive RR intervals were recorded along 5min and analyzed with Symbolic Analysis (SA) method. 0V%, 1V% and 2V% patterns were quantified and compared between groups. A linear mixed model analysis was used to determine between-group differences in symbolic analysis parameters (0V%, 1V% and 2V%), taken groups as fixed factor and sex, use of ACE inhibitors and Angiotensin II receptor type I blockers as random factors. The Bayesian analysis was carried out to check the magnitude of the evidence. The results of this study indicate that older adults carrying the DD genotype have statistically greater sympathetic modulation (0V%) and poor sympathovagal balance (1V%), but the Bayesian analysis indicate only an anecdotal effect. Sympathetic predominance is recognized a worrying condition, since may predisposes to cardiovascular risk.

Abstract 12938: An Unusual Case of Malignant Hypertension and Stress Cardiomyopathy Originating From the Urinary Bladder

A 39-year-old man with hypertension presented for an elective knee surgery. Within 15 minutes of induction of anesthesia, he developed malignant hypertension and acute hypoxia. Surgery wasaborted and he was subsequently transferred to our facility. High-sensitivity troponin was elevated. Chest X-ray demonstrated bilateral hilar opacities, consistent with pulmonary edema.Transthoracic echocardiography demonstrated mildly depressed left ventricular function with hypokinesis of the septum and inferolateral wall. Cardiac catheterization showed normal filling pressures and no coronary artery disease. Initial work up for secondary hypertension, including Duplex Doppler ultrasonography of renal artery and serum aldosterone level were unrevealing. Because of high index of suspicion, additional workup was pursued for adrenal hypertension. Hewas found to have severely elevated plasma normetanephrine level (36 nmol/L) and 24-hrurinary normetanephrine of 8,990 mcg while plasma metanephrine and epinephrine levels were within normal limits. Computed tomography of abdomen showed no adrenal mass but revealed contrast-enhancing mass in the bladder wall with surrounding lymphadenopathy, suggestive of metastatic paraganglioma. He underwent genetic evaluation which identified a heterozy gouspathogenic variant in the succinate dehydrogenase subunit B (SDHB) gene. He was treated withalpha- and beta-blockade and underwent partial cystectomy with lymph node dissection. Follow-up Gallium-68 DOTATATE scan was positive for uptake in several lymph nodes withsubsequent successful lymph node dissection. He is now asymptomatic. Discussion: This case illustrates the importance of a complete history in the evaluation of hypertension inyoung people. The presence of labile hypertension and acute cardiomyopathy which isprecipitated by stress or noncardiac surgery should prompt an evaluation of pheochromocytoma.The isolated elevation in plasma and urinary normetanephrine with normal plasma/urinarymetanephrine level is consistent with extra-adrenal production of catecholamines, which iscommon in the presence of SDHB mutation.

Артериальная гипертензия у лиц молодого возраста: основные факторы риска развития

Артериальная гипертензия у лиц молодого возраста: основные факторы риска развития

Audit on the recognition and response to hypertension in young people with type 1 diabetes mellitus

Audit on the recognition and response to hypertension in young people with type 1 diabetes mellitus

P955Prevalence of arterial hypertension in young people during military conflict in Donbass region

P955Prevalence of arterial hypertension in young people during military conflict in Donbass region