Prevalence Of Isolated Systolic Hypertension Research Articles

Prevalence and risk factors for isolated systolic hypertension among the oldest-old population in southwestern China: A community-based cross-sectional study.

The prevalence of isolated systolic hypertension (ISH) has doubled between 2002-2005 and 2014 among the oldest-old population in China. However, the prevalence and characteristics of ISH among the oldest-old population in southwestern China remain less known. This study aimed to investigate the prevalence of ISH among the oldest-old population in Chengdu and identify associated factors to provide valuable information for disease etiology and prevention. We recruited 1,312 participants aged over 80 years by using a stratified cluster sampling method between September 2015 and June 2016, from three districts (Jinjiang, Qingyang, and Longquanyi) of Chengdu, the largest city of southwest China. A structured questionnaire, anthropometric data, and blood pressure were collected according to the standard method. Blood pressure was measured three times by using a standardized mercury sphygmomanometer after a 10-minute seated rest. Of 1312 participants, 53.0% (n=695) had ISH. The prevalence of ISH in men and women was 54.7% and 51.3%, respectively, with no significant sex difference (P=.222). The prevalence of ISH increased with advanced age in men (P for trend=0.029), 52.5% for the 80-84 years group, 55.2% for the 85-89 years group, and 70.4% for the 90-98 years group, respectively. Multivariable logistic regression analyses found that drinking (OR=1.85, 95%CI=1.26-2.71), being overweight (OR=1.88, 95%CI=1.19-2.96), and having a higher heart rate (OR=0.66, 95%CI=0.51-0.86) were associated with ISH. Stratified by sex, these three factors remained significant in men. Our work highlights that the burden of ISH is substantial among the oldest-old population in southwestern China.

Isolated Systolic Hypertension among Diabetes Mellitus Subjects; a national cross-sectional study in Indonesia

Isolated systolic hypertension (ISH) reflects atherosclerosis. Studies reported hypertension prevalence among diabetes mellitus (DM); however, limited studies provided community prevalence. The present study aimed to explore ISH prevalence among DM in Indonesia. This study obtained data from the 2018 Indonesia Basic Health Survey. The DM category was determined by fasting plasma glucose (PG) level ≥126 mg/dL or 2 hours postprandial and random PG level ≥200 mg/dL or previously diagnosed by a doctor. ISH is categorized if systolic blood pressure is≥140 mmHg and diastolic blood pressure is 90 mmHg. This study also explored the subject’s determinants, i.e., compliance, demography, and lipid profile. A Chi-square and Binary logistic regression were used to determine the association. The study included 3,911 DM individuals and disclosed the prevalence of ISH at 17.5%. ≥65 years old (OR=13.61 95%CI: 3.297-19.365) and 45-64 years old OR=4.59 95%CI: 3.297-6.383)), high HDL-cholesterol (OR=0.77; 95%CI: 0.626-0.936), and longer DM duration (OR=2.89; 95%CI: 2.405-3.474), all together were related to the ISH. Subjects with the oldest age category, i.e., ≥65 years old, had the highest OR. Older DM individuals with low HDL-C and longer DM duration were related to the ISH, suggesting lipid profile treatments, mainly the HDL-C, is a pivotal effort to delay ISH.

Prevalence and Risk Factors of Isolated Systolic Hypertension among Diabetes Mellitus Subjects; a national cross-sectional study in Indonesia

Isolated systolic hypertension (ISH) reflects atherosclerosis. Studies reported hypertension prevalence among diabetes mellitus (DM); however, limited studies provided community prevalence. Present study aimed to explore ISH prevalence among DM in Indonesia. This study obtained data from the 2018 Indonesian basic health survey. The DM category was determined by fasting plasma glucose (PG) level ≥126 mg/dL or 2-hours postprandial and random PG level ≥200 mg/dL or previously diagnosed by a doctor. ISH is categorized if systolic blood pressure is≥140 mmHg and diastolic blood pressure is 90 mmHg. This study also explored the subject's determinants, i.e., compliance, demography, and lipid profile. A Chi-square and Binary logistic regression were used to determine the association. The study included 3,911 DM individuals and disclosed the prevalence of ISH 17.5%. ≥65 years old (OR=13.61 95%CI: 3.297-19.365) and 45-64 years old OR=4.59 95%CI: 3.297-6.383)), high HDL-cholesterol (OR=0.77; 95%CI: 0.626-0.936), and longer DM duration (OR=2.89; 95%CI: 2.405-3.474), all together were related to the ISH.  Subjects with the oldest age category, i.e., ≥65 years old, had the highest OR. Older DM individuals with low HDL-C and longer DM duration were related to the ISH, suggesting lipid profile treatments, mainly the HDL-C, is a pivotal effort to delay ISH.

Prevalence and determinants of isolated systolic and isolated diastolic hypertension in India: Insights from the national family health survey (NFHS)- 4.

Isolated Systolic Hypertension (ISH) and Isolated Diastolic Hypertension (IDH) are often the ignored forms of hypertension and are determinants of future cardiac and neurological events and contribute to mortality. However, the nationally representative estimates of both these forms of hypertension remain unknown from India. To estimate the ISH and IDH from a nationally representative survey of India. The present study used data from 7,23,181 people (15-54 years), recorded during the fourth round (2015-2016) of the National Family Health Survey (NFHS), India. The prevalence of ISH and IDH was calculated for state comparison, while multilevel logistic regression analysis was done to assess the correlates of both types of hypertension. The prevalence of ISH and IDH was found to be 1.2% (95% CI 1.0-1.4) and 5.7% (95% CI 5.2-6.2), respectively. The prevalence of both ISH and IDH increased with age, with a more significant increase in systolic pressure towards the higher age. Northeastern states of India (Assam, Meghalaya, and Arunachal Pradesh) had the highest prevalence of both forms of hypertension. On multilevel logistic regression, male gender, increasing age groups (highest odds ratio (OR) being in 45-49 year age group), alcohol, and diabetes positively predicted both ISH and IDH. Urban residence, literacy, and tobacco were positive predictors of IDH, whereas urban residence, smoking, and literacy negatively predicted ISH. ISH and IDH have a significant presence among the population of India. This data provides insights to formulate strategies at the primary and primordial prevention levels.

A Community-Based Study on Waist-to-Height Ratio: An Indicator for Systolic Hypertension in a Rural Community of Hilly Region.

The prevalence of hypertension gradually becomes a serious public health threat as it is a very pertinent risk factor for cardiovascular and cerebrovascular diseases. This study aims to estimate the prevalence of isolated systolic hypertension (ISH) among the hilly region's rural community and identify the indicators of ISH among study participants. A community-based cross-sectional study was conducted among 1220 participants in the rural community of the hilly region. A multistage random sampling technique was applied to recruit the participants. Demographic and anthropometric dimensions were measured to analyze the outcome of the study. The participants' mean age was 44.42 ± 15.54 years, with a majority of 822 female participants (67.40%). The prevalence of ISH was found as 27.45%. A statistically significant positive correlation (p < 0.05) of the waist-to-height ratio (WHtR) and body mass index (BMI) were observed with systolic blood pressure (SBP) in male as well as female participants, whereas BMI and WHtR had no correlation with diastolic blood pressure (DBP). Among female participants, the area under the curve (AUC) for BMI and WHtR was 0.604 (95% confidence interval 0.565-0.643, p-value = 0.020*) and 0.622 (95% confidence interval 0.584-0.660, p-value = 0.020*), respectively. Among male participants, the AUC for BMI and WHtR was 0.574 and 0.592, respectively. Hence, it cannot be considered very satisfactory. The increasing prevalence of ISH in a rural community is also a public health concern. At the preliminary stage, anthropocentric measurements are the primary tool for a family physician while treating the patients. This study concluded that WHtR is a better indicator than BMI for systolic hypertension. Although we have not observed a strong correlation of WHtR with systolic hypertension, it is required to perform future research to support this study's evidence.

Identifying Isolated Systolic Hypertension From Upper-Arm Cuff Blood Pressure Compared With Invasive Measurements.

Isolated systolic hypertension (ISH) is the most common form of hypertension and is highly prevalent in older people. We recently showed differences between upper-arm cuff and invasive blood pressure (BP) become greater with increasing age, which could influence correct identification of ISH. This study sought to determine the difference between identification of ISH by cuff BP compared with invasive BP. Cuff BP and invasive aortic BP were measured in 1695 subjects (median 64 years, interquartile range [55-72], 68% male) from the INSPECT (Invasive Blood Pressure Consortium) database. Data were recorded during coronary angiography among 29 studies, using 21 different cuff BP devices. ISH was defined as ≥130/<80 mm Hg using cuff BP compared with invasive aortic BP as the reference. The prevalence of ISH was 24% (n=407) according to cuff BP but 38% (n=642) according to invasive aortic BP. There was fair agreement (Cohen κ, 0.36) and 72% concordance between cuff and invasive aortic BP for identifying ISH. Among the 28% of subjects (n=471) with misclassification of ISH status by cuff BP, 20% (n=96) of the difference was due to lower cuff systolic BP compared with invasive aortic systolic BP (mean, -16.4 mm Hg [95% CI, -18.7 to -14.1]), whereas 49% (n=231) was from higher cuff diastolic BP compared with invasive aortic diastolic BP (+14.2 mm Hg [95% CI, 11.5-16.9]). In conclusion, compared with invasive BP, cuff BP fails to identify ISH in a sizeable portion of older people and demonstrates the need to improve cuff BP measurements.

Isolated systolic hypertension in Asia.

Isolated systolic hypertension (ISH) is the most common type of essential hypertension in the elderly and young adults. With rapid industrialization and population aging, the prevalence of ISH in Asia will rise substantially. Asian populations have distinct epidemiological features, risk factors and are especially vulnerable to ISH. There is a pressing need for Asian countries to formulate their unique strategies for control of ISH. In this review, we focus on the (1) epidemiology and pathophysiology, (2) risk factors and impact on outcomes, and (3) treatment goal and strategy for ISH in Asia.

Differences in prevalence of hypertension subtypes according to the 2018 Korean Society of Hypertension and 2017 American College of Cardiology/American Heart Association guidelines: The Korean National Health and Nutrition Examination Survey, 2007\u20132017 (KNHANES IV-VII)

BackgroundThe significance of high systolic and diastolic blood pressure remains controversial. We assessed the differences in prevalence of hypertension and its subtypes according to the different hypertension diagnostic criteria embodied by the 2017 American College of Cardiology/American Heart Association (2017 ACC/AHA) and 2018 Korean Society of Hypertension (2018 KSH) guidelines.MethodsWe used the 2007–2017 Korea National Health and Nutrition Examination Survey (KNHANES) data to calculate guideline-specific hypertension prevalence among untreated, adult participants. By the 2017 ACC/AHA guideline, a mean SBP ≥130 mmHg, DBP ≥80 mmHg, or currently using antihypertensive medications were considered to have hypertension. Isolated diastolic hypertension (IDH) was defined as DBP ≥80 mmHg and SBP <130 mmHg, isolated systolic hypertension (ISH) as SBP ≥130 mmHg and DBP <80 mmHg, and systolic diastolic hypertension (SDH) as SBP ≥130 mmHg and DBP ≥80 mmHg. In a similar manner, by the 2018 KSH guideline, all hypertension and its subtype prevalence were calculated using the 140/90 mmHg cutoff. The two versions of all hypertension and its corresponding subtype prevalence were calculated among all study participants and separately by sex and age then compared via analysis of variance.ResultsThe prevalence of all hypertension increased from 25.9% (95% confidence interval (CI) 25.4–26.5) defined by the 2018 KSH guideline to 46.3% (95% CI 45.6–46.9) classified by the 2017 ACC/AHA guideline. Such increase was primarily manifested through substantial increase in IDH prevalence, from 5.2% (95% CI 4.9–5.4) defined by the 2018 KSH guideline to 17.9% (95% CI 17.4–18.3) defined by the 2017 ACC/AHA guideline, and was most notably observed in young age groups, 30-49 years. ISH prevalence showed minimal differences. SDH prevalence moderately increased from 3.5% (95% CI 3.3–3.7) defined by the 2018 KSH guideline to 11.1% (95% CI 10.7–11.4) defined by the 2017 ACC/AHA guideline, achieved primarily among participants aged 50 years or above.ConclusionsChanges in each subtype prevalence made differential contribution to additionally classified hypertension cases by the 2017 ACC/AHA guideline. Future studies should investigate the diastolic-associated cardiovascular risks and benefits of its long-term primary prevention in the young population.

ISOLATED SYSTOLIC HYPERTENSION IS MORE PREVALENT IN PERSONS WITH DIABETES

Prior studies have demonstrated that the prevalence of isolated systolic hypertension (ISH) increases with age. We examined whether the presence of diabetes mellitus (DM) relates to an earlier increased prevalence of ISH. We studied adults with untreated hypertension (HTN), defined as a systolic

Prevalence and risk factors of isolated systolic hypertension among the elderly population in Davangere, Karnataka

Background: The WHO has estimated that globally hypertension is directly responsible for about 62% of cerebrovascular disease and 49% of ischemic heart disease. The risks of stroke and coronary heart disease are directly related to both levels of systolic and diastolic blood pressure. Research studies have shown that isolated systolic hypertension (ISH) confers a substantial cardiovascular risk and stroke; however, prevention and treatment lead to lowering of cardiovascular morbidity and mortality. Objectives: The objectives of this study were (1) to assess the prevalence of ISH in population aged ≥60 years in the rural field practice area of JJM Medical College, Davangere, and (2) to identify risk factors of ISH. Materials and Methods: It is a community-based cross-sectional study conducted among the elderly ≥60 years of age in the rural field practice area of JJM Medical College, Davangere. Statistical analysis was performed using, percentage, proportion, Chi‑square, and multivariate analysis. Results: A total of 780 subjects were studied. Majority of the elderly in our study belonged to the age group of 60–69 years (59.5%) with the mean age of 65 years (standard deviation ± 5.44). It was observed that majority of the elderly were males (55.4%) and majority were Hindu by religion (93.3%). In the present study, the overall prevalence of ISH was 25%, which was 26.4% in males and 23.6% among females. A significant increase in the prevalence of ISH was seen with an increase in age. Conclusion: Multivariate analysis showed age, high salt intake, less fruits consumption, lack of physical activity, and high body mass index which were significant independent risk factors of ISH.

[PP.11.14] PREVALENCE OF CARDIOVASCULAR DISEASE RISK FACTORS AMONG VISITORS OF HEALTH CENTERS IN 2010–2015

Objective: The aim of our study was to assess the prevalence of hypercholesterolemia (HH), obesity, hypertension, high-normal blood pressure and isolated systolic hypertension (ISH) as cardiovascular disease risk factors among visitors of Health Centers (HC) in Russia and its regions. Design and method: The data of 435299 men and women aged 25–64 years who visited HC in more than 20 regions of Russia from 2010 to 2015 were analyzed. Results: The prevalence of HH in men and women was 30.4% and 25.9% consecutively, obesity - 15.7% and 21.6%, hypertension - 19.3% and 15.1%. The prevalence of high-normal blood pressure among visitors of HC aged 20–85 was 17.7% and 14.4% in men and women respectively (total prevalence 15.9%). Prevalence of ISH was 6.5% in men, 8.3% in women (total prevalence 7.5%). Stage 1 ISH was observed in 16.6% of women and 16.7% of men (16.7% of sample), the prevalence of stage 2 was 5.9% in both men and women (5.9% of sample), stage 3 ISH was in 1.7% of men and 1.8% of women (1.8% of sample). HH and obesity are found to be more common in women, hypertension - in men. Standardized evaluation of obesity prevalence varies depending on the region from 10.3% in Kurgan region to 48.5% in Belgorod region, hypertension - from 12.4% in Kurgan region to 55.0% in Bryansk region, HH - from 24.1% in Moscow to 60.9% in Saratov region. According to the standardized evaluation the prevalence of obesity, HH and hypertension in Moscow, Kurgan region and Chuvash republic is lower than in average in Russia. Obesity in Belgorod region (48.5%), hypertension in Bryansk region (55.0%) and HH in Saratov region (60.9%) are two times more prevalent than in average in Russia. Conclusions: Analysis of the cardiovascular risk factors in visitors of the HC in Russia revealed a favorable situation in Moscow, Kurgan region and the Chuvash Republic. However, in most regions, the prevalence of obesity, hypertension and HH is quite high, suggesting the need to enhance measures for the prevention of cardiovascular diseases, changing lifestyle and food habits, correction of therapy.

Determinants of isolated systolic hypertension among diabetic patients visiting the diabetic clinic at the Tamale Teaching Hospital, Northern Ghana.

Hypertension and diabetes mellitus, two of the leading risk factors for atherosclerosis, are associated with numerous complications, including heart attacks and strokes. This study established the prevalence and determinants of isolated systolic hypertension (ISH) in diabetes mellitus patients visiting the Tamale Teaching Hospital. In this purposive cross-sectional study, 107 diabetes mellitus patients were recruited from the out-patient diabetes clinic of the Tamale Teaching Hospital (TTH). Blood and urine samples were collected for the estimation of fasting blood glucose (FBG) and routine urinalysis respectively. A well-structured pre-tested questionnaire was used to obtain socio-demographic data and clinical history of participants, and their blood pressure measured with a mercury sphygmomanometer. The prevalence of ISH among the participants was 37.4%. Mean age and FBG were significantly higher among participants with ISH than the normotensives (56.20 ± 10.60 v 48.44 ± 11.6, P= 0.022; and 8.80 ± 3.06 v 6.01 ± 0.50, P= 0.034 respectively). Type of diabetes mellitus was associated with ISH (P= 0.010) and age was a risk factor of ISH (OR= 1.057, P= 0.008). Isolated systolic hypertension was prevalent in 37.4% of diabetes mellitus patients and was associated with older age. Effective measures should, therefore, be instituted to prevent ISH in patients with type 2 diabetes especially the elderly.

Isolated Systolic Hypertension in Young People Is Not Spurious and Should Be Treated: Con Side of the Argument.

Isolated systolic hypertension (ISH) in young people, defined on the basis of brachial blood pressure (BP) as a systolic BP (SBP) of at least 140 mm Hg with a diastolic BP (DBP) of <90 mm Hg, is not an unusual condition and is increasing in prevalence.1–3 To date, this concept has been confronted with challenges in the mechanisms, clinical relevance, and consequences. Parameters other than brachial BP, such as noninvasive central hemodynamics, have introduced new insights to the condition. Nevertheless, grounded information supporting the long-term consequences is still lacking; therefore, the necessity to decide to treat or not to treat is a matter of concern in clinical practice.4 The current knowledge of ISH in young people is presented with an emphasis on the elements that are relevant to deciding that treatment is not needed. The prevalence of ISH reported among the young ranges widely, from 2% to 8% in population studies, and between 14% and 50% in patients with hypertension.3 This is a result of the differences in population characteristics, such as age, ethnicity, and obesity. The Enigma study in the UK confirmed that ISH is the most common form of hypertension (HTN) in young adults aged 17 to 27 years, with a prevalence of 8%.1 Data from the National Health and Nutrition Examination Survey indicate that among younger and middle-aged adults in the US, aged 18 to 39 years, the overall prevalence of ISH between 1988 and 1994 was 0.7%. This reached 1.6% (2.23% in males and 0.92% in females) between 1999 and 2004. Obesity, smoking, and low socioeconomic status seem to be important determinants of ISH among young adults.2 In a United States pediatric population of 12- to 16-year olds, the most prevalent hypertensive subtype was ISH.5 Similarly, in Spanish obese youths, …

Prevalence of isolated systolic hypertension (ISH) in Slovene hypertensive patients: insights from the "Quality of Healthcare in Slovenia" project.

The aim of the present study was mainly to evaluate age- and gender-dependent isolated systolic hypertension (ISH) prevalence before and during antihypertensive treatment, and to evaluate pulse pressure (PP) distributions during antihypertensive treatment in almost 20,000 Slovene hypertensive patients. The study was conducted as part of the "Quality of Healthcare in Slovenia" project, in agreement with the National Medical Ethics Committee of the Republic of Slovenia. Appropriate statistical analyses and evaluations were performed. The prevalence of ISH before the treatment was 19.6 % (17.0 % for men and 21.4 % for women) and it was significantly (p < 0.001) higher during the treatment (29.6 %; 26.4 % for men and 31.9 % for women). The mean PP before the treatment for the whole study patient sample was (71.2 ± 16.9) mmHg and was significantly (p < 0.001) reduced during the treatment to (57.4 ± 12.5) mmHg. With regard to high ISH in treated Slovene hypertensive patients, quality of ISH control may not be optimal and should be improved. On the other hand, the adequate arterial hypertension (AH) control (systolic blood pressure (SBP) < 140 mmHg and diastolic blood pressure (DBP) < 90 mmHg) was achieved in 55.6 % of patients. Our observations may have useful therapeutic implications in the management of AH, particularly ISH in the elderly.

Prevalence and trends of isolated systolic hypertension among untreated adults in the United States

The prevalence and long–term trends of isolated systolic hypertension (ISH) among untreated adults have not been reported. Data from 24,653 participants aged ≥18 years were selected from the National Health and Nutrition Examination Survey 1999–2010. The prevalence and 95% confidence intervals (CIs) of untreated ISH were estimated by conducting the independent survey t–test. The prevalence of untreated ISH was 9.4% and decreased from 10.3% in 1999–2004 to 8.5% in 2005–2010 (P = .00248). Old persons, females, and non–Hispanic blacks had higher prevalence of untreated ISH. Compared with 1999–2004, the prevalence of untreated ISH in 2005–2010 decreased among older (33.6%; 95% CI, 30.9%–36.3% vs. 25.1%; 95% CI, 22.7%–27.5%) and female individuals (8.3%; 95% CI, 7.5–9.2% vs. 11.4%; 95% CI, 10.4–12.3%). The stratified prevalence of untreated ISH declined in 2005–2010 (vs. 1999–2004) for older non–Hispanic whites (24.6% vs. 32.8%; P < .0001) and blacks (27.7% vs. 40.8%; P = .0013), non–Hispanic white females (7.5% vs. 10.8%; P < .0001), older individuals with higher education (21.0% vs. 30.6%; P = .0024), and females with lower education (10.1% vs. 13.1%; P = .006). Untreated ISH is more prevalent in older adults and females. Significant decreases in untreated ISH prevalence over time among these groups suggest that public health measures and/or treatment patterns are trending in the right direction.

Prevalence and changes of untreated isolated systolic hypertension among non-Hispanic black adults in the United States

Isolated systolic hypertension (ISH) is a growing health concern in the United States (US) black population. The stratified prevalence of untreated ISH has not been fully investigated in non-Hispanic blacks. Cross-sectional data on 4625 non-Hispanic blacks aged ⩾18 years were collected from the National Health and Nutrition Examination Survey 1999-2010, representing a probability sample of the US civilian noninstitutionalized black population. The 6-year prevalence of ISH and 95% confidence intervals (CIs) were estimated by conducting weighted frequency and logistic procedures. The prevalence of untreated ISH was 11.2% among non-Hispanic black adults in 1999-2010. Individuals who received lower education (high school or below) had higher prevalence of untreated ISH than those with higher education (12.8% (95% CI: 11.3-14.2%) vs. 9.0% (95% CI: 7.5-10.6%)). The prevalence of untreated ISH was higher in young men than in young women (4.3% (95% CI: 3.3-5.4%) vs. 1.8% (95% CI: 0.9-2.7%)), and higher in middle-aged adults with lower education than in middle-aged adults with higher education (14.1% (95% CI: 11.4-16.7%) vs. 7.7% (95% CI: 5.5-9.8%)). Compared with 1999-2004, the prevalence of untreated ISH in 2005-2010 decreased for old individuals (27.7% vs. 40.8%), old men (24.4% vs. 40.0%) and old individuals who received higher education (21.4% vs. 40.7%). Untreated ISH is more prevalent in old blacks, and significant reduction of the prevalence in this group suggests that public health interventions, lifestyle modifications or health awareness are in the right direction.

The prevalence of isolated systolic hypertension in adult populations from the Han, Uygur and Kazakh ethnic groups in Xinjiang, China

Objectives. To estimate the current prevalence and epidemiology of isolated systolic hypertension (ISH) among adult populations from different ethnic groups in Xinjiang province and to further establish a theoretical basis for developing personalized therapeutic strategies for hypertensive populations. Methods. To analyze the prevalence and risk factors of ISH in different ethnic groups in Xinjiang province, a cluster sampling method was adopted to conduct a cross-sectional study on people aged 35 years and older from the Han, Uygur and Kazakh populations in the Urumqi, Kelamayi, Hetian, Zhaosu, Fukang, Tulufan and Fuhai. Results. A total of 14,618 adults were surveyed with a response rate of 88.80%. The overall prevalence of ISH was 11.95% (men: 10.84% vs women: 12.92%); the prevalence of ISH in women was significantly higher (χ2 = 15.06, p = 0.00) than that in men. The prevalence varied significantly with age (χ2 = 822.71, p = 0.00) and increased in the elderly (χ2 = 769.59, p = 0.00). A logistic regression analysis revealed that age, obesity, diabetes and dyslipidemia are major risk factors for ISH; patients with hypertension combined with obesity or diabetes are at a high risk of ISH. Conclusions. The prevalence of ISH in Xinjiang is higher than average and exhibits a gender difference. There is a trend of increased prevalence with increasing age. Populations with obesity, diabetes or dyslipidemia, and patients who have hypertension combined with obesity and/or diabetes, should be aware of early preventive interventions.

Abstract 9736: Identification of Phenotypes at Risk of Transition from Systo-Diastolic Hypertension to Isolated Systolic Hypertension

Background: Isolated Systolic Hypertension (ISH) is the most frequent subtype of uncontrolled hypertension in elderly patients and is associated with high cardiovascular (CV) risk. Little is known about the natural evolution towards this type of hypertension and the CV phenotype associated with its appearance. Aim of the present study was to detect predictors of evolution towards ISH in subjects with initial systo-diastolic hypertension (SDH). Methods: 6,027 individuals with SDH (age 53±11 years, 57% men, systolic blood pressure [SBP] 159±21, diastolic blood pressure [DBP] 99±10), without prevalent CV disease, MDRD-estimated glomerular filtrate ratio (eGFR)&gt;30mL/mmHg/1.73 m2 , and with at least 6 month-follow up were selected from the CampaniaSalute registry. Echocardiography and carotid ultrasound were performed. The diagnosis of ISH was made at the end of follow up according to the ESH/ESC and JNCVII Guidelines (SBP ≥140 mmHg with DBP&lt;90 mmHg). Results: After a mean follow up period of 55±44 months, 19% of the study population exhibited ISH (n=1122). Patients with ISH were older, more often women and more often diabetic, and exhibited higher initial SBP, HDL-cholesterol, left ventricular (LV) mass, relative wall thickness, pulse pressure/stroke index ratio (PP/SVi), more severe carotid atherosclerosis and lower values of eGFR (all p&lt;0.001). These differences were studied using a multivariate proportional hazard model (Cox) including all variables that were found different at the descriptive analysis. Presence of ISH at follow up was independently predicted by older age (p&lt;0.0001; HR=1.20/5 years; CI=1.12-1.28), female gender (p&lt;0.004; HR=1.22; CI=1.06-1.40), baseline higher LV mass index (p=0.04;HR=1.04/5g*m-2.7; CI=1.01-1.05), higher carotid intima-media thickness (p=0.02; HR=1.12/mm; CI=1.02-1.22) and higher PP/SVi (p&lt;0.0001;HR=1.35/Unit); CI=1.23-1.48). Conclusion: Factors influencing the transition from SDH to ISH are older age, female gender and signs of CV target organ damage. Thus, a prompt and aggressive therapy for arterial hypertension before the onset of target organ damage appears desirable to help lowering the prevalence of ISH especially in elderly female patients.

Isolated Systolic Hypertension and its Determinants - A Cross-sectional Study in the Adult Population of Lucknow District in North India.

Objectives:1) To determine the prevalence of isolated systolic hypertension (ISH) in the adult population of Lucknow district. 2) To study the determinants of ISH especially the relationship with age.Materials and Methods:A community-based cross-sectional study was conducted in four randomly selected areas of Lucknow district. A total of 800 subjects, aged 20 years and above, 400 from urban and 400 from rural area of Lucknow district were included in the study. The statistical tools used for analysis were Pearson's Chi-square test and multiple logistic regression.Results:The prevalence of ISH according to JNC-7 criteria was 4.3%, which was 5.1% in men and 3.6% in women. A significant increase in the prevalence of ISH was seen with an increase in age. Multivariate logistic regression analysis of the determinants showed that age, BMI and smoking were significant independent risk factors of ISH.Conclusions:Given the risk of cardiovascular disease associated with ISH, the findings of this study emphasize the need for further research to document the impact of modifiable risk factors of ISH and the effect of hypertension screening and specific health promotion in bringing down the burden of ISH and related cardiovascular morbidity.

Prevalence and determinants of isolated systolic hypertension among young adults: the 1999-2004 US National Health And Nutrition Examination Survey.

Little is known about isolated systolic hypertension (ISH) in younger adults. We examined the prevalence and determinants of ISH in this age group using the 1999-2004 National Health and Nutrition Examination Surveys (NHANES) and made comparisons using data from NHANES III (1988-1994). A total of 5685 adults aged 18-39 years and not on antihypertensive medications were analyzed. Prevalence estimates of ISH and potential risk factors were estimated by age and sex. For comparison of prevalence estimates with published reports of NHANES III data, age cutoffs (18-24, 25-34, and 35-44 year) by sex were also employed. A multivariate logistic regression model tested independent determinants of ISH. ISH in young adults had a higher prevalence than systolic/diastolic hypertension (1.57 +/- 0.23% vs. 0.93 +/- 0.18%). ISH prevalence increased within the last decade particularly for men for each respective age category [men (0.8 vs. 2.2%, 1.3 vs. 2.4%, 1.3 vs. 2.4%), women (0.0 vs. 0.3%, 0.1 vs. 0.7%, 1.7 vs. 1.8%)]. On multivariate analysis, obesity [odds ratio (OR): 2.68, 95% confidence interval (CI): 1.06, 6.77], male sex (OR: 2.19, 95% CI: 1.10, 4.37), education level less than high school (OR: 2.98, 95% CI: 1.10, 8.06), and current smoking (OR: 2.06, 95% CI: 1.03, 4.11) were characteristics independently associated with higher odds of ISH among young adults. Relative increases in prevalence between the surveys were noted for current smoking (24.3 vs. 51.5%), obesity (33.9 vs. 42.7%) and low educational level (18.4 vs. 38.6%). ISH among young adults is increasing in prevalence, and is more common than systolic/diastolic hypertension. Obesity, smoking, and low socioeconomic status appear to be important determinants of ISH among young adults and have all increased over the last decade.