Phenotypes of arterial pressure in young men

Aim. To study with the use of repetitive clinical measurements and 24-hour arterial pressure (AP) monitoring phenotypes of AP in young men aged 18-25 years with history of elevation of AP at accidental determination. Material and methods. We examined 194 young men (mean age 21.1±2.1 years) because of detection of elevated AP at casual measurements. Clinical AP was assessed at repetitive determinations in sitting position at the same time on 5 consecutive days. 24-hour AP monitoring (24-HAPM) was carried out according to standard method. Classification of AP level and phenotype was made in accordance with recommendations of European Society of Arterial Hypertension (AH) (2007). Results. Optimal clinical AP was found in 13 (6.7%), normal AP - in 20 (10.3%), high normal AP - in 24 (12,4%), stable AH - in 107 (55.2%) young men. Eighty one persons (41.8%) had I, 20 (10.3%) - II, and 6 (3.1%) - III degree AH. Among studied patients with stable elevation of clinical AP rate of isolated systolic AH (ISAH) was 65.4%, systole-diastolic AH - 6.1%, isolated diastolic AH - 8.4%. Comparison of levels of clinical AP and 24-HAPM showed that 34 young men (17.5%) had white coat hypertension, 73 (37.6%) - had true AH, 13 (6.7%) - concealed AH. The level of clinical SAP turned out to be the sole predictor of concealed AH. Among examined persons 40 (20.6%) had 1,57 (29.4%) - 2, 34 (17.5%) - 3 or more additional risk factors. Sixty one subjects (31.4%) had metabolic syndrome. No association was established between number of risk factors, presence of metabolic syndrome, and AP phenotype. Left ventricular hypertrophy was revealed in 24.4% of patients with true AH and in 15.2% - with concealed AH. Conclusion. Dominating type of AH in young men is ISAH. The data obtained evidence for importance of 24-HAPM for establishment of AP phenotype in young men with normal and high normal clinical AP.