Intensity of cardiovascular and behavioral risk factors in masked and stable arterial hypertension in young subjects
https://doi.org/10.18705/1607-419X-2016-22-3-244-252
Abstract
Objective. To study the intensity of cardiovascular behavioral and other risk factors of masked arterial hypertension (MHTN) and stable arterial hypertension (SHTN) in young subjects (students of medical university).
Design and methods. A full-design screening study included 423 young men and women aged 20–27, mean age 22, 59 % were women and 41 % — men. All subjects underwent clinical examination: physical examination — height, weight, body mass index (BMI), waist and hip circumferences, questionnaires to assess behavioral risk factors and history of the complaints; laboratory and instrumental screening: fasting serum creatinine, lipid profile (total cholesterol, triglycerides, high density lipoproteins, low density lipoproteins), 30‑second breath-hold test, standard 12‑lead electrocardiography (ECG); echocardiography and 24‑hour blood pressure monitoring in HTN subjects (with MHTN and SHTN).
Results. MHTN was detected in 12,3 % subjects, SHTN — in 9 %; 78,7 % were normotensives. Subjects with SHTN were overweight — BMI 28,4 (27,4; 29,7) kg/m 2. In MHTN subjects, waist and circumferences tended to increase: 77,2 (65,1; 82) and 98 (93,2; 104) cm, respectively. MHTN patients demonstrated higher office systolic blood pressure as compared to normotensives: 120 (110; 130) versus 108,5 (100; 118) mm Hg. However, they had lower BP compared to subjects with SHTN — 139 (132,3; 140) mm Hg. Family history of early cardiovascular diseases was detected in all MHTN patients (100 %), as well as in 50 % SHTN individuals and in 56 % normotensives. The highest prevalence of behavioral risk factors was found in a group of subjects with MHTN, as compared to those with SHTN and normotensives.
Conclusions. Subjects with MHTN and SHTN have prevalent indicators of behavioral and other risk factors for HTN, which form its phenotype. The development of MHTN and SHTN in young subjects is associated with the severity of clinical, genetic and behavioral risk factors.
About the Authors
N. P. LyaminaRussian Federation
MD, PhD, DSc, Professor, Department of the Therapy, Department of General Medicine, Saratov State Medical University named after V. I. Razumovskiy, Vice-director for Science, Research Institute of Cardiology, Saratov State Medical University named after V. I. Razumovskiy
A. V. Nalivaeva
Russian Federation
MD, PhD Student, Department of Therapy, Department of General Medicine, Saratov State Medical University named after V. I. Razumovskiy
V. N. Senchikhin
Russian Federation
MD, PhD, Senior Researcher, Research Institute of Cardiology, Saratov State Medical University named after V. I. Razumovskiy
T. P. Lipchanskaya
Russian Federation
MD, PhD, Researcher, Research Institute of Cardiology, Saratov State Medical University named after V. I. Razumovskiy
References
1. Golubnitschaya O, Costigliola V, EPMA. General report and recommendations in predictive, preventive and personalized medicine 2012: White Paper of the European Association for Predictive, Preventive and Personalized Medicine. The EPMA J. 2012;3:14. doi: 10.1186/1878–5085–3-14
2. Неинфекционные заболевания. Сайт Всемирной организации здравоохранения. Информационный бюллетень № 355. Январь 2015 г. Доступно на: http://www.who.int/mediacentre/factsheets/fs355/ru/# (дата обращения: 25.03.2016 г.) [Non-infectious diseases. Web site of World Health Organization. Bulletin № 355. Jan 2015. Available at: http://www.who.int/mediacentre/factsheets/fs355/ru/# [Internet]. Available from: http://www.who.int/mediacentre/factsheets/fs355/ru/#. (date of access — 25.03.2016). In Russian].
3. Каминский И. П., Огородова Л. М., Патрушев М. В., Чулок А. А. Медицина будущего: возможности для прорыва сквозь призму технологического прогноза. Форсайт. 2013;7(1):14–27. [Kaminskiy IP, Ogorodova LM, Patrushev MV, Chulok AA. Medicine of the future: possibilities for the breakthrough in the prism of technological forecasting. Forsight. 2013;7(1):14–27. In Russian].
4. Mozaffarian D, Fahimi S, Singh GM, Micha R, Khatibzadeh S, Engell RE et al. Global burden of diseases nutrition and chronic diseases expert group. Global sodium consumption and death from cardiovascular causes. N Engl J Med. 2014;371(7):624–34. doi:10.1056/NEJMoa1304127
5. Табак. Сайт Всемирной организации здравоохранения (ВОЗ). Информационный бюллетень. № 339. Май 2015 г. Доступно на: http://www.who.int/mediacentre/factsheets/fs339/ru/(дата обращения: 25.03.2016 г. [Tabacco. Web-site of World Health Organization. Bulletin № 339. May 2015. [Internet]. Available from: http://www.who.int/mediacentre/factsheets/fs339/ru/. (date of access — 25.03.2016). In Russian].
6. Чазова И. Е., Жернакова Ю. В., Ощепкова Е. В., Шальнова С. А., Яровая Е. Б., Конради А. О. и др. Распространенность факторов риска развития сердечно-сосудистых заболеваний в российской популяции больных артериальной гипертонией. Кардиология. 2014;54(10):4–12. [Chazova IE, Zhernakova JuV, Oshhepkova EV, Shal’nova SA, Yarovaya EB, Konradi AO et al. Prevalence of risk factors of cardiovascular diseases in Russian population of patients with arterial hypertension. Kardiologiia. 2014;54(10):4–12. In Russian].
7. Fagard RH, Cornelissen VA. Incidence of cardiovascular events in white-coat, masked and sustained hypertension vs. true normotension: a meta-analysis. J Hypertens. 2007;25(11):2193– 2198.
8. Ohkubo T, Kikuya M, Metoki H, Asayama K, Obara T, Hashimoto J et al. Prognosis of «masked» hypertension and «whitecoat » hypertension detected by 24‑h ambulatory blood pressure monitoring 10‑year follow-up from the Ohasama study. J Am Coll Cardiolgy. 2005;46(3):508–515.
9. Pickering T, Eguchi K, Kario K. Masked hypertension: a review. J Hypertens Res. 2007;30(6):479–488. doi:10.1291/hypres. 30.479
10. Mancia G, Bombelli M, Facchetti R, Madotto F, Quarti-Trevano F, Polo Friz H et al. Long- term risk of sustained hypertension in white-coat or masked hypertension. J Нypertens. 2009;54(2):226–232. doi: 10.1161/HYPERTENSIONAHA
11. 2013 ESH/ESC Guidelines for the management of arterial hypertension. The Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Journal of Hypertension. 2013;31(7):1281–1357. doi:10.1097/01.hjh.0000431740.32696.cc
12. Лямина Н. П., Лямина С. В., Сенчихин В. Н., Додина К. А. Функциональная проба для выявления латентной артериальной гипертензии у лиц молодого возраста. Кардиология. 2011;51(4):28–30. [Lyamina NP, Lyamina SV, Senchikhin VN, Dodina KA. Functional test on latent arterial hypertension detection in young adults. Kardiologiia. 2011;51(4):28–30. In Russian].
13. Лямина Н. П., Смит М. Л., Наливаева А. В. Лямина С. В., Манухина Е. В., Сенчихин В. Н. и др. Прогностическая ценность теста 30‑секундной задержки дыхания в диагностике маскированной артериальной гипертензии у лиц молодого возраста. Фарматека. 2015;9:63–67. [Lyamina NP, Smit ML, Nalivaeva AV, Lyamina SV, Manuhina EV, Senchikhin VN et al. Prognostic value of 30‑sec breath hold test in diagnostics of masked arterial hypertension in young adults. Farmateka. 2015;9:63–67. In Russian].
14. Lyamina NP, Smith ML, Lyamina SV, Manukhina EB, Senchikhin VN, Pacchia CF et al. Pressor response to 30‑s breathhold: a predictor of masked hypertension. J Blood Press. 2012;21(6):372–376. doi: 10.3109/08037051.2012.694213
15. Michikawa T, Nishiwaki Y, Okamura T, Asakura K, Nakano M, Takebayashi T. The taste of salt measured by a simple test and blood pressure in Japanese women and men. Hypertens Res. 2009;32(5):399–403. doi: 10.1038/hr.2009.31.
Review
For citations:
Lyamina N.P., Nalivaeva A.V., Senchikhin V.N., Lipchanskaya T.P. Intensity of cardiovascular and behavioral risk factors in masked and stable arterial hypertension in young subjects. "Arterial’naya Gipertenziya" ("Arterial Hypertension"). 2016;22(3):244-252. https://doi.org/10.18705/1607-419X-2016-22-3-244-252