Isolated systolic hypertension: data on a cohort of young subjects from a French working population (IHPAF)

Abstract

Elderly patients with isolated systolic hypertension (ISH)Fsystolic blood pressure (SBP) X140 mmHg and diastolic blood pressure (DBP) o90 mmHgFhave increased mortality and morbidity. The aim was to study the incidence of ISH in a younger population of between 15 and 60 years of age, and to measure pulse pressure (PP), mean arterial pressure (MAP) and heart rate (HR) in these subjects. The study population consisted of 27 783 subjects, aged 15-60 years, untreated for hypertension (HT) from a cohort of employees formed to study the incidence of HT in the French working population (AIHFP). BP and HR were measured with a validated, automatic device after 5, 6 and 7 min at rest. The prevalence of ISH was 6.9% in men, 2.3% in women. This prevalence was over 5% in young men and increased at 40-44 years; it was negligible in young women, but increased at 50-54 years to about 10% (ie to the same level as in men of the same age): PP in subjects with ISH (46.9 mmHg) was significantly higher than in the normotensive group (NTF40.9 mmHg); it was comparable in both young men (65.5 mmHg) and older men (66 mmHg); it was higher in men (63.1 mmHg) than in women (61.5 mmHg). HR was higher in ISH than in NT and it was higher in women (E5 bpm) in whom it decreased with age. The prevalence of ISH is not negligible in HT (30% men, 25% women), with a high prevalence in young subjects and elevated PP, MAP and HR values. These data should be taken into account as elevated ISH, PP and HR are considered as cardiovascular risk factors.

Isolated systolic hypertension — evaluation of the scale of the problem among medical students — pilot study

“…In our study, ISH was detected in 18% of the studied population, being also the predominant form of hypertension (78%). These results are comparable to the French study, in which 60% of young hypertensive men had ISH [12].…”

Office Pulse Pressure Is a Predictor of Favorable Outcome in Young- to Middle-Aged Subjects With Stage 1 Hypertension

“…4 However, an elevated PP often associated with isolated systolic hypertension (ISH) may be found also among young individuals, particularly in men, as documented by several studies. [5][6][7][8] The clinical significance of these conditions in youth is still controversial for the obvious necessity of a long-term follow-up to accumulate a sufficient number of hard end points. The first authors who highlighted a different prognostic value of PP according to age were Sesso et al 9 Considering both PP and mean blood pressure (MBP) in the same multivariable survival model, these authors observed that in a general male population, PP had an important predictive capacity for cardiovascular disease only among people aged ≥60 years, whereas among people aged <60 years, PP only had a marginal predictive value.…”

Increased Stroke Volume and Aortic Stiffness Contribute to Isolated Systolic Hypertension in Young Adults

“…8 Although the mechanisms underlying ISH in younger individuals are poorly understood, two recent reports suggest that exaggerated pulse pressure (PP) amplification may be responsible and, hence, the terms "pseudo" or "spurious" hypertension have been applied. 9,10 However, in both studies, central PP appeared to be elevated in the ISH subjects compared with normotensive individuals, suggesting that ISH in young individuals may not be benign.…”