The cardiovascular phenotype of elevated blood pressure differs markedly between young males and females: The Enigma Study

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cam.issuedOnline2018-10-15
cam.orpheus.successThu Jan 30 10:51:48 GMT 2020 - The item has an open VoR version.
dc.contributor.authorMcEniery, CM
dc.contributor.authorNardin, Chiara
dc.contributor.authorMaki-Petaja, Kaisa
dc.contributor.authorMiles, Karen
dc.contributor.authorYasmin, Yasmin
dc.contributor.authorMcDonnell, Barry
dc.contributor.authorCockcroft, John
dc.contributor.authorWilkinson, Ian
dc.contributor.orcidMcEniery, Carmel [0000-0003-3636-0705]
dc.contributor.orcidMaki-Petaja, Kaisa [0000-0001-7312-6200]
dc.contributor.orcidWilkinson, Ian [0000-0001-6598-9399]
dc.date.accessioned2019-02-01T10:06:32Z
dc.date.available2019-02-01T10:06:32Z
dc.date.issued2018-12
dc.description.abstractBlood pressure in young adults predicts blood pressure in later life. We aimed to identify metabolic, haemodynamic and autonomic characteristics associated with raised blood pressure in young adults and whether these differ between males and females. 3145 healthy subjects, aged 18-40 years, were grouped according to sex and blood pressure category following the recent reclassification of blood pressure as part of American Heart Association/American College of Cardiology 2017 guidelines. All individuals undertook a lifestyle and medical history questionnaire, and detailed metabolic, haemodynamic and autonomic assessments. Stage 1 hypertension and normal blood pressure were the most common blood pressure phenotypes in males (29%) and females (68%), respectively. In both sexes, cardiac output was positively associated with increasing blood pressure 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 blood pressure categories. Most heart rate variability indices decreased across the blood pressure categories, particularly in males. In young adults, metabolic and haemodynamic abnormalities associated with hypertension are already present at the elevated blood pressure stage and the overall phenotype differed markedly between sexes. While a “cardiac” phenotype was associated with elevated blood pressure and hypertension in males, a “vascular” phenotype, characterized by elevated peripheral vascular resistance, aortic pulse wave velocity and augmentation index, was dominant in females.
dc.identifier.doi10.17863/CAM.35931
dc.identifier.eissn1524-4563
dc.identifier.issn0194-911X
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/288667
dc.publisherWolters Kluwer Health
dc.publisher.urlhttps://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.118.11975
dc.rightsAttribution 4.0 International
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.subjectcardiac output
dc.subjecthypertension
dc.subjectvascular resistance
dc.subjectvascular stiffness
dc.subjectAdolescent
dc.subjectAdult
dc.subjectBlood Pressure
dc.subjectCardiac Output
dc.subjectFemale
dc.subjectHeart Rate
dc.subjectHemodynamics
dc.subjectHumans
dc.subjectHypertension
dc.subjectMale
dc.subjectPulse Wave Analysis
dc.subjectSex Characteristics
dc.subjectStroke Volume
dc.subjectVascular Resistance
dc.subjectVascular Stiffness
dc.subjectYoung Adult
dc.titleThe cardiovascular phenotype of elevated blood pressure differs markedly between young males and females: The Enigma Study
dc.typeArticle
dcterms.dateAccepted2018-09-19
prism.endingPage1284
prism.issueIdentifier6
prism.publicationNameHypertension
prism.startingPage1277
prism.volume72
pubs.funder-project-idBritish Heart Foundation (None)
pubs.funder-project-idCambridge University Hospitals NHS Foundation Trust (CUH) (unknown)
pubs.funder-project-idCambridge University Hospitals NHS Foundation Trust (CUH) (146281)
pubs.funder-project-idBritish Heart Foundation (None)
pubs.funder-project-idBritish Heart Foundation (None)
pubs.funder-project-idBritish Heart Foundation (None)
rioxxterms.licenseref.startdate2018-09-19
rioxxterms.licenseref.urihttp://creativecommons.org/licenses/by/4.0/
rioxxterms.typeJournal Article/Review
rioxxterms.versionVoR
rioxxterms.versionofrecord10.1161/HYPERTENSIONAHA.118.11975
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