Isolated systolic hypertension tied to increased LV mass index, aortic stiffness in adolescents

Adolescents with isolated systolic hypertension (ISH), including the spurious hypertension (sHTN) subtype, show more noticeable markers of cardiac end-organ damage, higher aortic stiffness, and stroke volume than those with white-coat hypertension (WCH), a study has shown.

In this study, the authors assessed a cohort of 73 patients with suspected primary hypertension (aged 13‒17 years; 13 girls) using cardiac magnetic resonance. Based on 24-hour ambulatory blood pressure (BP) monitoring, either ISH (n=30) or WCH (n=43) was diagnosed in these individuals.

Thirteen patients in the ISH group were classified as having sHTN and 17 with true hypertension based on noninvasive central BP measurement.

ISH patients showed higher indexed left ventricular mass index (LVMI; p<0.001), maximal left ventricular (LV) wall thickness (p<0.001), LV concentricity (p=0.001), and more often had LV hypertrophy (47 percent vs 14 percent; p=0.002) than adolescents with WCH.

ISH patients also had higher average pulse wave velocity (PWV) in the proximal aorta (p=0.016) and the whole thoracic aorta (p=0.008). Additionally, they had higher indexed LV stroke volume (p=0.025).

Moreover, the sHTN subgroup had significantly higher LVMI and aortic PWV, and more often had LV hypertrophy than the WCH group. The sHTN and true hypertension subgroups showed no difference in terms of aortic PWV, LVMI, or LV geometry.

It was assumed “that ISH with normal central BP in young patients is a benign phenomenon and was hence labeled spurious hypertension,” the authors said.