Latent arterial hypertension in young women with excessive body mass and obesity

Objective. To evaluate the occurrence of latent hypertension and to analyze the indicators of 24-hour ambulatory blood pressure monitoring (24-h ABPM) in comparison with other phenotypes of increased blood pressure in young women with excessive body mass and obesity. Design and methods. The study included 104 women aged 18 to 35 years. Inclusion criteria: overweight with body mass index (BMI) ≥ 25,0 kg/m2. All subjects underwent 24-h ABPM with an oscillometric sensor using the BPLab Vasotens device (Peter Telegin LLC, Russia). More than 20 indicators were evaluated. The risk factor (RF) profile was also studied, including indicators of the lipid profile, fasting glucose level and HOMA-IR index (“Homeostasis Model Assessment of insulin resistance”). Based on the instrumental examination, four groups were formed: group 1 — persistent normotension (control); group 2 — white coat hypertension (WCH); group 3 — latent hypertension; group 4 — persistent hypertension. Data processing was carried out using the Statistica 10.0 software package (StatSoft Inc., USA). Results. Among young women with overweight and obesity, the frequency of normotension, WCH, latent hypertension and stable hypertension was 28,8 %, 9,6 %, 30,8 % and 30,8 %. In women with persistent hypertension, SBPday and DBPday indicators exceeded the control by 15 % (P1–4 < 0,01) and 17,2 % (P1–4 < 0,01), but with latent hypertension — by 10,3 % (P1–3 < 0,01) and by 7,7 % (P1–3 < 0,01); time index (TI) SBP was 4,9 times higher (P1–4 < 0,01), TI DBP was 7,1 times higher (P1–4 < 0,01), and in latent hypertension it was 3,8 times higher (P1–3 < 0,01) and TI DBP was 2,5 times higher (P1–3 < 0,01). A similar trend was noted in some of the indicators during night sleep. The variability of SBP and DBP in daytime hours was slightly higher with latent hypertension, and at night — with stable hypertension. Women with latent versus persistent hypertension differed significantly by daytime values, while nocturnal data were almost equivalent. The highest value of PBP 24 was found in the group with latent hypertension compared to the control (P1–3 < 0,01). In WCH group, as expected, both daytime and nighttime values did not tend to increase compared to the control group, and some were even significantly lower. In groups with latent and stable hypertension the rates of non-dippers by SBP and DBP were the same. Conclusion. Every second young woman with overweight or obesity has latent hypertension and stable hypertension, which should be taken into account when developing individualized preventive intervention programs among young women, depending on the variant of BP regulation in the presence of excessive body mass and obesity.

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