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Publications

Journal Article Ahead of print

PubMed: 42299866 DOI: 10.1097/HJH.0000000000004376

Novel hypertension phenotypes based on cross-classification of 24-h brachial and aortic SBP.

J Hypertens

Authors: Elpida Athanasopoulou, Thomas Weber, James E Sharman, Siegfried Wassertheurer, Mohsen Agharazii, Antonios Argyris, Sola Aoun Bahous, Jose R Banegas, Ronald K Binder, Jacques Blacher, Andréa Araujo Brandao, Kathrin Danninger, Peter Fitscha, Cristina Giannattasio, Eugenia Gkaliagkousi, Annelise Machado Gomes de Paiva, Auxiliadora Graciani, Bernhard Hametner, Piotr Jankowski, Fotios Karachalias, Kazuomi Kario, Anastasios Kollias, Antonios Lazaridis, Yan Li, Alessandro Maloberti, Christopher C Mayer, Barry J McDonnell, Carmel M McEniery, Marco Antonio Mota-Gomes, Maria Lorenza Muiesan, János Nemcsik, Anna Paini, Sabine Perl, Gary L Pierce, Daniel Piskorz, Giacomo Pucci, Eva Reininghaus, Bernd Reininghaus, Enrique Rodilla Sala, Aletta E Schutte, Petros P Sfikakis, Alejandro de la Sierra, George S Stergiou, Dimitrios Terentes-Printzios, Charalambos Vlachopoulos, Lisa J Ware, Ian B Wilkinson, Yi Zhang, Athanase D Protogerou

Affiliations

  • Cardiovascular Prevention and Research Unit, Clinic-Laboratory of Pathophysiology & 1st Department of Internal Propaedeutic Medicine, Laiko Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
  • Cardiology Department, Klinikum Wels-Grieskirchen, Wels, Austria.
  • Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia.
  • Austrian Institute of Technology, Vienna, Austria.
  • Département de Médecine, Faculté, Université Laval.
  • Axe Endocrinologie-Néphrologie, Centre de recherche du CHU de Québec-Univrsité Laval, Québec City, Quebec, Canada.
  • Lebanese American University School of Medicine, Byblos, Lebanon.
  • Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid and CIBER in Epidemiology and Public Health (CIBERESP), Madrid, Spain.
  • AP-HP Centre-Université de Paris, Hôpital Hôtel-Dieu, Centre de diagnostic et de thérapeutique, Paris, France.
  • Medical Sciences Faculty, State University of Rio de Janeiro, Rio de Janeiro, Brazil.
  • Center for Internal Medicine, Vienna, Austria.
  • School of Medicine and Surgery, Milano-Bicocca University, Cardiology 4, ASST GOM Niguarda, Milan, Italy.
  • 3rd Department of Internal Medicine, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece.
  • Dr Marco Mota Clinical Research Center - Cesmac University Center, Alagoas, Brazil.
  • Department of Internal Medicine and Geriatric Cardiology, Medical Center for Postgraduate Education, Warsaw, Poland.
  • Jichi Medical University School of Medicine, Shimotsuke, Japan.
  • Hypertension Center STRIDE-7, National and Kapodistrian University of Athens, School of Medicine, Third Department of Medicine, Sotiria Hospital, Athens, Greece.
  • Department of Cardiovascular Medicine, Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
  • Centre for Cardiovascular Research, Innovation and Development (CURIAD), Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff.
  • Experimental Medicine and Immunotherapeutics (EMIT), Addenbrooke's Hospital, University of Cambridge, UK.
  • Centro per la Prevenzione e Cura dell'ipertensione Arteriosa, Department of Clinical and Experimental Sciences, University of Brescia and ASST Spedali Civili, Brescia, Italy.
  • Department of Family Medicine, Semmelweis University, Budapest, Hungary.
  • Department of Cardiology, Medical University Graz, Austria.
  • Department of Health and Human Physiology, University of Iowa, Iowa City, Iowa, USA.
  • Cardiovascular Research Center, British Sanatorium, Buenos Aires, Argentina.
  • Unit of Internal and Translational Medicine, Terni Hospital, Department of Medicine and Surgery, University of Perugia, Perugia, Italy.
  • Medical University of Graz, division of Psychiatry and psychotherapeutic medicine, Graz, Austria.
  • Universidad Cardenal Herrera-CEU, CEU Universities, Hospital de Sagunto, Valencia, Spain.
  • School of Population Health, University of New South Wales, The George Institute for Global Health, Sydney, New South Wales, Australia.
  • Hypertension in Africa Research Team (HART), SAMRC Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa.
  • Hospital Mutua Terrassa, University of Barcelona, Barcelona, Spain.
  • First Department of Cardiology, Hippokration General Hospital, National and Kapodistrian University of Athens, Athens, Greece.
  • SAMRC/Wits Developmental Pathways for Health Research Unit, University of the Witwatersrand, Johannesburg, South Africa.
  • Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.

Abstract

BACKGROUND

Novel hypertension phenotypes are described by cross-classification of brachial and aortic SBP (brSBP/aoSBP).

OBJECTIVES

The aim of this study is to examine their prevalence and age and sex-distribution, factors that potentially modulate them, and their association with left ventricular hypertrophy (LVH).

METHODS

Data on 24-h ambulatory BP monitoring (ABPM) using the Mobilograph device (IEM GmbH, Stolberg, Germany) and LVH from the International 24-h Ambulatory aortic Blood pressure Consortium (i24ABC) were retrieved from 31 centers (17 countries). The population was categorized into four phenotypes; concordant systolic normotension (CSN: both SBPs normal), isolated brachial systolic hypertension (IbrSH: high brSBP/normal aoSBP), isolated aortic systolic hypertension (IaoSH: normal brSBP/high aoSBP), and concordant systolic hypertension (CSH: both SBPs high).

RESULTS

In 8738 participants (age: 58.4 ± 15.1 years; 51.8% men), the prevalence of IaoSH was 7.7%, being more prevalent in men, and presenting a U-shape age-distribution in them compared to a linear distribution in females. IaoSH was associated with lower heart rate and beta-blockade medications. The prevalence of IbrSH was 6.5%, presenting an inverted U-shape age-distribution; it was higher in the presence of higher heart rate and calcium channel-blockade. In 2307 individuals with LVH data, after adjustment for age, sex, DBP, IaoSH - but not IbrSH - had 2.6 higher odds of LVH compared to CSN (95% confidence interval, 1.7-3.9) and similar to CSH.

CONCLUSION

IaoSH and IbrSH amounted to almost 15% and showed specific clinic characteristics. Only IaoSH was significantly associated with LVH. Outcome-driven randomized controlled trials are needed to further investigate their clinical relevance.

MeSH

Hypertension, Hypertrophy, Left Ventricular, Heart Rate, Heart, Cardiovascular Diseases, Blood Pressure, Phenotype, Classification, Prevalence, Sex, Blood Pressure Monitoring, Ambulatory