I.N. POSOKHOV¹, E.A. PRASKURNICHIY1, 2

 ¹A.I. Burnazyan State Scientific Center of the Russian Federation, Moscow

²Russian Federal Academy of Continued Medical Education Healthcare Ministry of Russia, Moscow

 Contact details:

Posokhov I.N. — MD, Professor of the Therapy Department

Address: 23 Marshal Novikov St., Moscow, Russian Federation, 123098, tel.: +7-925-646-82-81, e-mail: igor@posohov.ru

Isolated systolic hypertension in the young (ISHY) is more common among men, or among obese people, or among athletes and active population groups, which determines its heterogeneity. The close interlacement of neurohumoral and metabolic factors forms a stable background for hypertension. In some cases, ISHY is associated with uneven increase of arterial stiffening with age. However, the absent «interlacement» of factors in the presence of increased stroke volume and hyperkinetic circulation is potentially dangerous in terms of hemodynamic transition and the formation of blood pressure trajectories, leading in the future to established hypertension and cardiovascular complications. The review systematizes the recent literature data on risk factors and pathogenesis of ISHY.

Key words: arterial hypertension, the youth, risk factors, pathogenesis.

REFERENCES

1. Williams B., Mancia G., Spiering W. et al; ESC Scientific Document Group. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J, 2018, Sep. 1, vol. 39 (33), pp. 3021–3104.
2. Saladini F. Isolated systolic hypertension in the young. A heterogeneous condition. Minerva Med, 2021, May 14. DOI: 10.23736/S0026-4806.21.07627-8. Epub ahead of print. PMID: 33988016.
3. Palatini P. The HARVEST. Looking for optimal management of young people with stage 1 hypertension. Panminerva Med, 2021, Mar 12. DOI: 10.23736/S0031-0808.21.04350-0. Epub ahead of print. PMID: 33709681.
4. O’Rourke M.F., Vlachopoulos C., Graham R.M. Spurious systolic hypertension in youth. Vasc Med, 2000, vol. 5, pp. 141–145.
5. Lurbe E., Redon J. Isolated Systolic Hypertension in Young People Is Not Spurious and Should Be Treated: Con Side of the Argument. Hypertension, 2016, Aug, vol. 68 (2), pp. 276–280.
6. Liu X., Rodriguez C.J., Wang K. Prevalence and trends of isolated systolic hypertension among untreated adults in the United States. J Am Soc Hypertens, 2015, Mar, vol. 9 (3), pp. 197–205.
7. Mallion J.M., Hamici L., Chatellier G., Lang T., Plouin P.F., De Gaudemaris R. Isolated systolic hypertension: data on a cohort of young subjects from a French working population (IHPAF). J Hum Hypertens, 2003, vol. 17, pp. 93–100.
8. Saladini F., Dorigatti F., Santonastaso M., Mos L., Ragazzo F., Bortolazzi A. et al., HARVEST Study Group. Natural history of hypertension subtypes in young and middle-age adults. Am J Hypertens, 2009, vol. 22, pp. 531–537.
9. Staessen J., Amery A., Fagard R. Isolated systolic hypertension in the elderly. J Hypertens, 1990, vol. 8, pp. 393–405.
10. Chiolero A., Cachat F., Burnier M., Paccaud F., Bovet P. Prevalence of hypertension in schoolchildren based on repeated measure­ments and association with overweight. J Hypertens, 2007, vol. 25, pp. 2209–2217.
11. Cheung E.L., Bell C.S., Samuel J.P., Poffenbarger T., Redwine K.M., Samuels J.A. Race and obesity in adolescent hypertension. Pediatrics, 2017, vol. 139, pii: e20161433.
12. Karatzi K., Protogerou A.D., Moschonis G., Tsirimiagou C., Androutsos O., Chrousos G.P. et al. Prevalence of hypertension and hypertension phenotypes by age and gender among schoolchildren in Greece: the Healthy Growth Study. Atherosclerosis, 2017, vol. 259, pp. 128–133.
13. Wills A.K., Lawlor D.A., Muniz-Terrera G., Matthews F., Cooper R., Ghosh A.K. et al., FALCon Study Team. Population heterogeneity in trajecto­ries of midlife blood pressure. Epidemiology, 2012, vol. 23, pp. 203–211.
14. Syme C., Abrahamowicz M., Leonard G.T., Perron M., Richer L., Veillette S. et al. Sex differences in blood pressure and its relationship to body composition and metabolism in adolescence. Arch Pediatr Adolesc Med, 2009, vol. 163, pp. 818–825.
15. Tsai T.Y., Cheng H.M., Chuang S.Y., Chia Y.C., Soenarta A.A., Minh H.V., Siddique S., Turana Y., Tay J.C., Kario K., Chen C.H. Isolated systolic hypertension in Asia. J Clin Hypertens (Greenwich), 2021, Mar, vol. 23 (3), pp. 467–474. DOI: 10.1111/jch.14111. Epub 2020 Nov 29. PMID: 33249701.
16. Lund-Johansen P. Twenty-year follow-up of hemodynamics in essen­tial hypertension during rest and exercise. Hypertension, 1991, vol. 18 (5 Suppl), pp. III54–III61.
17. Julius S., Randall O.S., Esler M.D., Kashima T., Ellis T., Bennet J. Altered cardiac responsiveness and regulation in the normal cardiac output type of borderline hypertension. Circ Res, 1975, vol. 36 (6 Suppl 1), pp. 199–207.
18. Julius S., Krause L., Schork N.J., Mejia A., Jones K.A., Van den Ven C. et al. Hyperkinetic borderline hypertension in Tecumseh, Michigan. J Hypertens, 1991, vol. 9, pp. 77–84.
19. Julius S., Jamerson K., Mejia A., Krause L., Schork N., Jones K. The Association of borderline hypertension with target organ damage and higher coronary risk. JAMA, 1990, vol. 264, pp. 354–358.
20. Egan B., Panis R., Schork N., Julius S. Mechanism of increased alpha adrenergic vasoconstriction in human essential hypertension. J Clin Invest, 1987, vol. 80, pp. 812–817.
21. Alfie J., Majul C., Paez O., Galarza C., Waisman G. Hemodynamic significance of high brachial pulse pressure in young men. Clin Exp Hypertens, 2004, vol. 26, pp. 199–207.
22. Mangoni A.A., Mircoli L., Giannattasio C., Ferrari A.U., Mancia G. Heart rate-dependence of arterial distensibility in vivo. J Hypertens, 1996, vol. 14, pp. 897–901.
23. Giannattasio C., Vincenti A., Failla M., Capra A., Ciro` A., De Ceglia S. et al. Effects of heart rate changes on arterial distensibility in humans. Hypertension, 2003, vol. 42, pp. 253–256.
24. Tomiyama H., Hashimoto H., Tanaka H., Matsumoto C., Odaira M., Yamada J. et al., baPWV/cfPWV Collaboration Group. Synergistic relationship between changes in the pulse wave velocity and changes in the heart rate in middle-aged Japanese adults: a prospective study. J Hypertens, 2010, vol. 28, pp. 687–694.
25. McEniery C.M., Yasmin. Wallace S., Maki-Petaja K., McDonnell B., Sharman J.E. et al., ENIGMA Study Investigators. Increased stroke volume and aortic stiffness contribute to isolated systolic hypertension in young adults. Hypertension, 2005, vol. 46, pp. 221–226.
26. Avolio A.P., Chen S.G., Wang R.P., Zhang C.L., Li M.F., O’Rourke M.F. Effects of aging on changing arterial compliance and left ventricular load in a northern Chinese urban community. Circulation, 1983, vol. 68, pp. 50–58.
27. Latham R.D., Westerhof N., Sipkema P., Rubal B.J., Reuderink P., Murgo J.P. Regional wave travel and reflections along the human aorta: a study with six simultaneous micromanometric pressures. Circulation, 1985, vol. 72, pp. 1257–1269.
28. O’Rourke M.F. Wave travel and reflection in the arterial system. J Hypertens, 1999, vol. 17, pp. S45–S47.
29. Yu S., McEniery C.M. Central Versus Peripheral Artery Stiffening and Cardiovascular Risk. Arterioscler. Thromb Vasc Biol, 2020, May, vol. 40 (5), pp. 1028–1033.
30. Segers P., Rietzschel E.R., Chirinos J.A. How to Measure Arterial Stiffness in Humans. Arterioscler Thromb Vasc Biol, 2020, May, vol. 40 (5), pp. 1034–1043.
31. Chirinos J.A., Segers P., Hughes T., Townsend R. Large-Artery Stiffness in Health and Disease: JACC State-of-the-Art Review. J Am Coll Cardiol, 2019, Sep 3, vol. 74 (9), pp. 1237–1263.
32. Jose A.D., Taylor R.R. Autonomic blockade by propranolol and atropine to study intrinsic myocardial function in man. J Clin Invest, 1969, vol. 48, pp 2019–2031.
33. Julius S., Pascual. London R. Role of parasympathetic inhibition in the hyperkinetic type of borderline hypertension. Circulation, 1971, vol. 44, pp. 413–418.
34. Esler M., Lambert G., Jennings G. Regional norepinephrine turnover in human hypertension. Clin Exp Hypertens, 1989, vol. 11 (Suppl 1), pp. 75–89.
35. Esler M., Jennings G., Lambert G., Meredith I., Horne M., Eisenhofer G. Overflow of catecholamine neurotransmitters to the circulation: source, fate and function. Physiol Rev, 1990, vol. 70, pp. 963–985.
36. Fisher J.P., Paton J.F. The sympathetic nervous system and blood pressure in humans: implications for hypertension. J Hum Hypertens, 2012, Aug, vol. 26 (8), pp. 463–475.
37. Bruno R.M., Ghiadoni L., Seravalle G., Dell’oro R., Taddei S., Grassi G. Sympathetic regulation of vascular function in health and disease. Front Physiol, 2012, vol. 3, pp. 284.
38. Strazzullo P., Barbato A., Galletti F., Barba G., Siani A., Iacone R. et al. Abnormalities of renal sodium handling in the metabolic syndrome. Results of the Olivetti Heart Study. J Hypertens, 2006, vol. 24, pp. 1633–1639.
39. Strazzullo P., Barbato A., Galletti F., Barba G., Siani A., Iacone R. et al. Abnormalities of renal sodium handling in the metabolic syndrome. Results of the Olivetti Heart Study. J Hypertens, 2006, vol. 24, pp. 1633–1639.
40. Middlemiss J.E., Miles K.L., McDonnell B.J., Yasmin. Maki-Petaja K.M., Cockcroft J.R. et al. Mechanisms underlying elevated SBP differ with adiposity in young adults: the Enigma study. J Hypertens, 2016, vol. 34, pp. 290–297.

41. D’Elia L., Strazzullo P. Excess Body Weight, Insulin Resistance and Isolated Systolic Hypertension: Potential Pathophysiological Links. High Blood Press Cardiovasc Prev, 2018, Mar, vol. 25 (1), pp. 17–23.
42. Gorzelniak K., Engeli S., Janke J., Luft F.C., Sharma A.M. Hormonal regulation of the human adipose-tissue renin-angiotensin system: relationship to obesity and hypertension. J Hypertens, 2002, vol. 20 (5), pp. 965–973.
43. Gorzelniak K., Engeli S., Janke J., Luft F.C., Sharma A.M. Hormonal regulation of the human adipose-tissue renin-angiotensin system: relationship to obesity and hypertension. J Hypertens, 2002, vol. 20 (5), pp. 965–973.
44. Gorzelniak K., Engeli S., Janke J., Luft F.C., Sharma A.M. Hormonal regulation of the human adipose-tissue renin-angiotensin system: relationship to obesity and hypertension. J Hypertens, 2002, vol. 20 (5), pp. 965–973.
45. World Health Organization. Reducing salt intake in populations: report of a WHO forum and technical meeting. Geneva: WHO, 2007. Pp. 1–60.
46. Donfrancesco C., Ippolito R., Lo Noce C., Palmieri L., Iacone R., Russo O., Vanuzzo D., Galletti F., Galeone D., Giampaoli S., Strazzullo P. Excess dietary sodium and inadequate potassium intake in Italy: results of the MINISAL study. Nutr Metab Cardiovasc Dis, 2013, vol. 23, pp. 850–856.
47. Ciura S., Bourque C.W. Transient receptor potential vanilloid 1 is required for intrinsic osmoreception in organum vasculosum lamina terminalis neurons and for normal thirst responses to systemic hyperosmolality. J Neurosci, 2006, vol. 26 (35), pp. 9069–9075.
48. Leenen F.H., Ruzicka M., Huang B.S. The brain and salt-sensitive hypertension. Curr Hypertens Rep, 2002, vol. 4, pp. 129–135.
49. Posokhov I.N., Sharykin S.A., Trunina I.I. Izolirovannaya sistolicheskaya gipertenziya i ambulatornoe monitorirovanie tsentral’nogo arterial’nogo davleniya u detey i podrostkov [Isolated systolic hypertension and ambulatory central blood pressure monitoring in children and adolescents]. Nizhniy Novgorod: DEKOM, 2019. 96 p.
50. Palatini P., Rosei E.A., Avolio A., Bilo G., Casiglia E., Ghiadoni L., Giannattasio C., Grassi G., Jelakovich B., Julius S., Mancia G., McEniery C.M., O’Rourke M.F., Parati G., Pauletto P., Pucci G., Saladini F., Strazzullo P., Tsioufis K., Wilkinson I.B., Zanchetti A. Isolated systolic hypertension in the young: a position paper endorsed by the European Society of Hypertension. J Hypertens, 2018, Jun, vol. 36 (6), pp. 1222–1236.
51. Schleich K.T., Smoot M.K., Ernst M.E. Hypertension in Athletes and Active Populations. Curr Hypertens Rep, 2016, Nov, vol. 18 (11), p. 77.
52. Berge H.M., Isern C.B., Berge E. Blood pressure and hypertension in athletes: a systematic review. Br J Sports Med, 2015, Jun, vol. 49 (11), pp. 716–723.
53. Sachtleben T., Fields K.B. Hypertension in the athlete. Curr Sports Med Rep, 2003, Apr, vol. 2 (2), pp. 79–83.
54. O’Rourke M., Avolio A., Stelliou V., Young J., Gallagher D.E. The rhythm of running: can the heart join in? Aust N Z J Med, 1993, vol. 23, pp. 708–710.
55. Folkow B., Haglund U., Jodal M., Lundgren O. Blood flow in the calf muscle of man during heavy rhythmic exercise. Acta Physiol Scand, 1971, vol. 81, pp. 157–163.
56. Vlachopoulos C., Kardara D., Anastasakis A., Baou K., Terentes-Printzios D., Tousoulis D. et al. Arterial stiffness and wave reflections in marathon runners. Am J Hypertens, 2010, vol. 23, pp. 974–979.
57. Laurent P., Marenco P., Castagna O., Smulyan H., Blacher J., Safar M.E. Differences in central systolic blood pressure and aortic stiffness between aerobically trained and sedentary individuals. J Am Soc Hypertensyu, — 2011, vol. 5, pp. 85–93.
58. Taylor B.A., Zaleski A.L., Capizzi J.A., Ballard K.D., Troyanos C., Baggish A.L. et al. Influence of chronic exercise on carotid atherosclerosis in marathon runners. BMJ Open, 2014, vol. 4, p. e004498.
59. Edwards D.G., Lang J.T. Augmentation index and systolic load are lower in competitive endurance athletes. Am J Hypertens, 2005, vol. 18 (5 Pt 1), pp. 679–683.
60. Stergiou G.S., Parati G., Vlachopoulos C. et al. Methodology and technology for peripheral and central blood pressure and blood pressure variability measurement: current status and future directions — Position statement of the European Society of Hypertension Working Group on blood pressure monitoring and cardiovascular variability. J Hypertens, 2016, Sep, vol. 34 (9), pp. 1665–1677.
61. Posokhov I. Ambulatory central blood pressure obtained by BPLab is questionable. Journal of Hypertension, 2021, April, vol. 39, p. e131.
62. McEniery C.M., Yasmin. Maki-Petaja K.M., McDonnell B.J., Munnery M., Hickson S.S. et al., Anglo-Cardiff Collaboration Trial Investigators. The impact of cardiovascular risk factors on aortic stiffness and wave reflections depends on age: the Anglo-Cardiff Collaborative Trial (ACCT III). Hypertension, 2010, vol. 56, pp. 591–597.
63. Saladini F., Fania C., Mos L., Mazzer A., Casiglia E., Palatini P. Office pulse pressure is a predictor of favourable outcome in young-to-middle-aged subjects with stage 1 hypertension. Hypertension, 2017. Epub ahead of print.
64. O’Rourke M.F., Adji A. Guidelines on Guidelines: focus on isolated systolic hypertension in youth. J Hypertens, 2013, vol. 31, pp. 649–654.
65. O’Rourke M.F., Adji A. Pressure paradox: high pulse pressure and low mean pressure are favorable features in young adults. Hypertension, 2017. Epub ahead of print.
66. Franklin S.S., Wong N.D. Hypertension and cardiovascular disease: contributions of the Framingham Heart Study. Glob Heart, 2013, vol. 8, pp. 49–57.
67. Franklin S.S., Gustin W. 4th, Wong N.D., Larson M.G., Weber M.A., Kannel W.B. et al. Hemodynamic patterns of age-related changes in blood pressure. The Framingham Heart Study. Circulation, 1997, vol. 96, pp. 308–315.
68. Uiterwaal C.S., Anthony S., Launer L.J., Witteman J.C., Trouwborst A.M., Hofman A., Grobbee D.E. Birth weight, growth, and blood pressure: an annual follow-up study of children aged 5 through 21 years. Hypertension, 1997, vol. 30 (2 Pt 1), pp. 267–271.
69. McEniery C.M., Yasmin. McDonnell B., Munnery M., Wallace S.M., Rowe C.V. et al., Anglo-Cardiff Collaborative Trial Investigators. Central pressure: variability and impact of cardiovascular risk factors: the Anglo-Cardiff Collaborative Trial II. Hypertension, 2008, vol. 51, pp. 1476–1482.
70. Yano Y., Stamler J., Garside D.B., Daviglus M.L., Franklin S.S., Carnethon M.R. et al. Isolated systolic hypertension in young and middle-aged adults and 31-year risk of cardiovascular mortality: the Chicago Heart Association Detection Project in Industry Study. J Am Coll Cardiol, 2015, vol. 65, pp. 327–335.
71. Aatola H., Koivistoinen T., Tuominen H., Juonala M., Lehtima¨ki T., Viikari J.S.A. et al. Influence of child and adult elevated blood pressure on adult arterial stiffness: The Cardiovascular Risk in Young Finns Study. Hypertension, 2017, vol. 70, pp. 531–536.
72. Mahmud A., Feely J. Spurious systolic hypertension of youth: fit young men with elastic arteries. Am J Hypertens, 2003, vol. 16, pp. 229–232.
73. McEniery C.M., Franklin S.S., Wilkinson I.B., Cockcroft J.R. Isolated systolic hypertension in the young: a need for clarity. J Hypertens, 2013, vol. 31, pp. 1911–1913.