Cardiovascular risk factors in younger adults with high-normal blood pressure and essential hypertension

2020 
A decreasing trend in the onset age of essential hypertension, asymptomatic course of the disease, and a high prevalence of high-normal blood pressure (pre-hypertension) among young people are predictors of excessive premature mortality. When working with young patients with pre-hypertension or hypertension, the correction of behavioral risk factors and reduction of cardiovascular risk are critical tasks to drive mortality down within the young population. However, there is a lack of knowledge about the prevalence of risk factors among young people. Updated information on the dynamics and variability of risk factors is largely absent. Besides, the assessment of the absolute risk of fatal cardiovascular events in young people is challenging because of the age-related limitations of SCORE riskometer. Objective. To assess the frequencies of cardiovascular risk factors in young people with pre-hypertension or hypertension. Material and Methods. A cross-sectional study included 112 people with pre-hypertension or hypertension aged 25 to 44 years. Patients underwent clinical, laboratory, and instrumental examinations and questionnaire survey. Results. The most common risk factor among young people with pre-hypertension or hypertension was overweight or obesity (65.6 ± 8.6%). The frequency of visceral obesity was 24.7 ± 7.8%. The frequency of smoking was 30.10 ± 8.24%, 41.5% and 3.6% in men and women, respectively (p = 0.0001). Hereditary history of early cardiovascular diseases was found in 57.0 ± 8.9%. The rates of hypercholesterolemia, hyperglycemia, and hyperuricemia were 50.5 ± 8.9%, 30 ± 8.2%, and 42.6 ± 8.8%, respectively. Hyperuricemia was more common in men (71%) than in women (12%), p < 0.01. In addition to reporting the main cardiovascular factors, the article presents data on the frequencies of nutritional risk factors, various types of low physical activity, and data on the frequency of anxiety and depression in young people with pre-hypertension and hypertension. Conclusions. Higher rates of overweight, smoking, and hyperuricemia, but lower rates of early cardiovascular history were found in men compared with women. Young people with pre-hypertension and hypertension had comparable incidence rates of major cardiovascular and behavioral risk factors, with the exception of more frequent dyslipidemia and hyperuricemia in the presence of hypertension. However, hyperuricemia, low high-density lipoprotein cholesterol, and excessive salt intake were detected more often in men with pre-hypertension than in women. In the group of hypertensive individuals, gender differences were characterized by higher frequencies of overweight, hyperuricemia, and smoking among men.
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