Abstract
Purpose/objective
While hypertension is an important contributor to cardiovascular disease (CVD) and its treatment has well-established mortality benefits, there is uncertainty as regards the management of isolated systolic hypertension (ISH). Furthermore, the association of ISH with CVD and mortality has been established, but the metabolic characteristics of the affected population have not as yet been adequately described. The aim of this study was to describe the metabolic profiles of patients with ISH.
Methods
An observational study of patients attending the Hypertension Unit of the University Hospital of Heraklion, Crete, Greece, was performed.
Results
In total, 809 hypertensive patients not on any antihypertensive treatment were identified. Among them, 44.7% were men, aged 55.6 ± 12.5 years, while 29.7% of both men and women were smokers. Systolic blood pressure was 161.3 ± 15.8 mmHg and diastolic blood pressure was 96.1 ± 11.3 mmHg. Body mass index (BMI) was 31 ± 5.3 kg/m2, while 9.6% had type 2 diabetes (T2D). A comparison of patients with ISH with those with hypertension, but not ISH, revealed that patients with ISH were older and had lower SBP and higher pulse pressure, while they also had lower total cholesterol and LDL and were more likely to have T2D, albeit they had a slightly lower BMI. On the other hand, they did not have any difference in terms of gender, smoking status, HDL, triglycerides, liver biochemistry, uric acid, or prevalence of impaired fasting glucose.
Conclusion
Patients with ISH were older, with lower SBP, total cholesterol, and LDL and higher pulse pressure and higher prevalence of diabetes.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
World Health Organization. Projections of mortality and burden of disease, 2004–2030. https://www.who.int/healthinfo/global_burden_disease/projections2004/en/. Accessed May 9, 2020
Tzoulaki I, Elliott P, Kontis V, Ezzati M (2016) Worldwide exposures to cardiovascular risk factors and associated health effects: current knowledge and data gaps. Circulation. 133:2314–2333. https://doi.org/10.1161/CIRCULATIONAHA.115.008718
Gupta A, Mackay J, Whitehouse A et al (2018) Long-term mortality after blood pressure-lowering and lipid-lowering treatment in patients with hypertension in the Anglo-Scandinavian cardiac outcomes trial (ASCOT) legacy study: 16-year follow-up results of a randomised factorial trial. Lancet. 392:1127–1137. https://doi.org/10.1016/S0140-6736(18)31776-8
Mancia G, Giannattasio C (2015) Diagnostic and therapeutic problems of isolated systolic hypertension. J Hypertens 33:33–43. https://doi.org/10.1097/HJH.0000000000000424
Williams B, Mancia G, Spiering W et al (2018) 2018 ESC/ESH guidelines for the management of arterial hypertension: the task force for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension: the task force for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension. J Hypertens 36:1953–2041. https://doi.org/10.1097/HJH.0000000000001940
American Diabetes Association (2019) 2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2019. Diabetes Care 42:S13–S28. https://doi.org/10.2337/dc19-S002
Bavishi C, Goel S, Messerli FH (2016) Isolated systolic hypertension: an update after SPRINT. Am J Med 129:1251–1258. https://doi.org/10.1016/j.amjmed.2016.08.032
Wright JT Jr, Fine LJ, Lackland DT, Ogedegbe G, Dennison Himmelfarb CR (2014) Evidence supporting a systolic blood pressure goal of less than 150 mm hg in patients aged 60 years or older: the minority view. Ann Intern Med 160:499–503. https://doi.org/10.7326/M13-2981
Mancia G, Fagard R, Narkiewicz K et al (2013) 2013 ESH/ESC guidelines for the management of arterial hypertension: the task force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens 31:1281–1357. https://doi.org/10.1097/01.hjh.0000431740.32696.cc
Saladini F, Palatini P (2017) Isolated systolic hypertension in young individuals: pathophysiological mechanisms, prognostic significance, and clinical implications. High Blood Press Cardiovasc Prev 24:133–139. https://doi.org/10.1007/s40292-017-0199-y
Palatini P, Saladini F, Mos L, Fania C, Mazzer A, Casiglia E (2018) Clinical characteristics and risk of hypertension needing treatment in young patients with systolic hypertension identified with ambulatory monitoring. J Hypertens 36:1810–1815. https://doi.org/10.1097/HJH.0000000000001754
El-Atat F, McFarlane SI, Sowers JR (2004) Diabetes, hypertension, and cardiovascular derangements: pathophysiology and management. Curr Hypertens Rep 6:215–223. https://doi.org/10.1007/s11906-004-0072-y
Smulyan H, Lieber A, Safar ME (2016) Hypertension, diabetes type II, and their association: role of arterial stiffness. Am J Hypertens 29:5–13. https://doi.org/10.1093/ajh/hpv107
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Ethical approval
The conduct of this study was approved by the ethical committee of the University Hospital of Heraklion, Crete.
Informed consent
Informed consent was provided by each participant for participation in this study.
Additional information
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Papadakis, J., Ioannou, P., Theodorakopoulou, V. et al. Metabolic profile of patients with isolated systolic hypertension. Hormones 20, 377–380 (2021). https://doi.org/10.1007/s42000-020-00266-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s42000-020-00266-y