Novel hypertension phenotypes based on cross-classification of 24-h brachial and aortic SBP.
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Athanasopoulou Elpida, Weber Thomas, Sharman James E, Wassertheurer Siegfried, Agharazii Mohsen, Argyris Antonios, Bahous Sola Aoun, Banegas Jose R, Binder Ronald K, Blacher Jacques, Brandao Andréa Araujo, Danninger Kathrin, Fitscha Peter, Giannattasio Cristina, Gkaliagkousi Eugenia, Gomes de Paiva Annelise Machado, Graciani Auxiliadora, Hametner Bernhard, Jankowski Piotr, Karachalias Fotios, Kario Kazuomi, Kollias Anastasios, Lazaridis Antonios, Li Yan, Maloberti Alessandro, Mayer Christopher C, McDonnell Barry J, McEniery Carmel M, Mota-Gomes Marco Antonio, Muiesan Maria Lorenza, Nemcsik János, Paini Anna, Perl Sabine, Pierce Gary L, Piskorz Daniel, Pucci Giacomo, Reininghaus Eva, Reininghaus Bernd, Rodilla Sala Enrique, Schutte Aletta E, Sfikakis Petros P, de la Sierra Alejandro, Stergiou George S, Terentes-Printzios Dimitrios, Vlachopoulos Charalambos, Ware Lisa J, Wilkinson Ian B, Zhang Yi, Protogerou Athanase D, International Academic 24-Hour Ambulatory Aortic Blood Pressure Consortium (i24abc.org)
Аннотация
OBJECTIVES: The aim of this study is to examine their prevalence and age and sex-distribution, factors that potentially modulate them, and their association with left ventricular hypertrophy (LVH).
METHODS: Data on 24-h ambulatory BP monitoring (ABPM) using the Mobilograph device (IEM GmbH, Stolberg, Germany) and LVH from the I nternational 24-h A mbulatory aortic B lood pressure C onsortium (i24ABC) were retrieved from 31 centers (17 countries). The population was categorized into four phenotypes; concordant systolic normotension (CSN: both SBPs normal), isolated brachial systolic hypertension (IbrSH: high brSBP/normal aoSBP), isolated aortic systolic hypertension (IaoSH: normal brSBP/high aoSBP), and concordant systolic hypertension (CSH: both SBPs high).
RESULTS: In 8738 participants (age: 58.4 ± 15.1 years; 51.8% men), the prevalence of IaoSH was 7.7%, being more prevalent in men, and presenting a U-shape age-distribution in them compared to a linear distribution in females. IaoSH was associated with lower heart rate and beta-blockade medications. The prevalence of IbrSH was 6.5%, presenting an inverted U-shape age-distribution; it was higher in the presence of higher heart rate and calcium channel-blockade. In 2307 individuals with LVH data, after adjustment for age, sex, DBP, IaoSH - but not IbrSH - had 2.6 higher odds of LVH compared to CSN (95% confidence interval, 1.7-3.9) and similar to CSH.
CONCLUSION: IaoSH and IbrSH amounted to almost 15% and showed specific clinic characteristics. Only IaoSH was significantly associated with LVH. Outcome-driven randomized controlled trials are needed to further investigate their clinical relevance.