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Cardiovascular Phenotype of Elevated Blood Pressure Differs Markedly Between Young Males and Females

Thumbnail
Author
Nardin, C.
Maki-Petaja, K.M.
Miles, K.L.
Yasmin
McDonnell, Barry
Cockcroft, John R.
Wilkinson, I.B.
McEniery, C.M.
Enigma Study Investigators
Date
2018-10-15
Acceptance date
2018-09-19
Type
Article
Publisher
American Heart Association
ISSN
0194-911X
1524-4563 (online)
Metadata
Show full item record
Abstract
Blood pressure (BP) in young adults predicts BP in later life. We aimed to identify metabolic, hemodynamic, and autonomic characteristics associated with raised BP in young adults and whether these differ between males and females. Three thousand one hundred forty-five healthy subjects, aged 18 to 40 years, were grouped according to sex and BP category following the recent reclassification of BP as part of American Heart Association/American College of Cardiology 2017 guidelines. All individuals undertook a lifestyle and medical history questionnaire and detailed metabolic, hemodynamic, and autonomic assessments. Stage 1 hypertension and normal BP were the most common BP phenotypes in males (29%) and females (68%), respectively. In both sexes, cardiac output was positively associated with increasing BP category (P<0.001 for both). Similar positive trends were observed for heart rate and stroke volume in males (P<0.001 for both) and heart rate in females (P<0.001). Unlike in males, peripheral vascular resistance, aortic pulse wave velocity, and augmentation index were significantly increased in hypertensive females (P<0.001 for all) compared with the other BP categories. Most heart rate variability indices decreased across the BP categories, particularly in males. In young adults, metabolic and hemodynamic abnormalities associated with hypertension are already present at the elevated BP stage and the overall phenotype differed markedly between sexes. Whereas a cardiac phenotype was associated with elevated BP and hypertension in males, a vascular phenotype, characterized by elevated peripheral vascular resistance, aortic pulse wave velocity, and augmentation index, was dominant in females.
Journal/conference proceeding
Hypertension;
Citation
Nardin, C., Maki-Petaja, K.M., Miles, K.L., Yasmin, McDonnell, B.J., Cockcroft, J.R., Wilkinson, I.B., McEniery, C.M. and Enigma Study Investigators (2018) 'Cardiovascular Phenotype of Elevated Blood Pressure Differs Markedly Between Young Males and Females: The Enigma Study', Hypertension, 72(6), pp.1277-1284.
URI
http://hdl.handle.net/10369/10210
DOI
https://doi.org/10.1161/HYPERTENSIONAHA.118.11975
Description
Article published in Hypertension, available open access at https://www.ahajournals.org/doi/suppl/10.1161/HYPERTENSIONAHA.118.11975
Rights
https://creativecommons.org/licenses/by/4.0/
Sponsorship
Cardiff Metropolitan University (Grant ID: Cardiff Metropolian (Internal))
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