TY - JOUR
T1 - Cardiovascular phenotype of elevated blood pressure differs markedly between young males and females the ENIGMA study
AU - Enigma Study Investigators
AU - Nardin, Chiara
AU - Maki-Petaja, Kaisa M.
AU - Miles, Karen L.
AU - McDonnell, Barry J.
AU - Cockcroft, John R.
AU - Wilkinson, Ian B.
AU - McEniery, Carmel M.
AU - Benedict, Samantha
AU - Cockcroft, John
AU - Dhakam, Zahid
AU - Day, Lisa
AU - Hickson, Stacey
AU - Maki-Petaja, Kaisa
AU - McDonnell, Barry
AU - Middlemiss, Jessica
AU - Miles, Karen
AU - Munnery, Maggie
AU - Pusalkar, Pawan
AU - Retallick, Christopher
AU - Sabit, Ramsey
AU - Sharman, James
AU - Smith, Jane
AU - Woodcock-Smith, Jean
AU - Thomas, Edna
AU - Wallace, Sharon
AU - Wilkinson, Ian
AU - Yasmin,
N1 - Publisher Copyright:
© 2018 The Authors.
PY - 2018/10/15
Y1 - 2018/10/15
N2 - 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.
AB - 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.
KW - Cardiac output
KW - Hypertension
KW - Vascular resistance
KW - Vascular stiffness
UR - http://www.scopus.com/inward/record.url?scp=85061589091&partnerID=8YFLogxK
U2 - 10.1161/HYPERTENSIONAHA.118.11975
DO - 10.1161/HYPERTENSIONAHA.118.11975
M3 - Article
C2 - 30763511
AN - SCOPUS:85061589091
SN - 0194-911X
VL - 72
SP - 1277
EP - 1284
JO - Hypertension
JF - Hypertension
IS - 6
ER -