Clinical, laboratory and instrumental characteristics of naive young and middle-aged patients with essential hypertension: data from real-world outpatient clinical practice

Background. Hypertension is currently recognized as a major health problem in young and middle-aged adults and is associated with a substantial deterioration in prognosis, underscoring the importance of early diagnosis and timely risk factor control.

Objective. To assess the clinical, laboratory, and instrumental characteristics of naive young and middle-aged patients with essential hypertension in real-world outpatient clinical practice.

Methods: study included 73 patients with essential hypertension (median age, 41.0 [37.0; 48.0] years; women, 53.4 %) with stage I-III, grade 1-2 hypertension who had not previously received antihypertensive therapy. Clinical characteristics, office blood pressure (BP), ambulatory blood pressure monitoring (ABPM), echocardiography, and routine clinical and biochemical blood test parameters were evaluated.

Results. Most patients had grade 1 hypertension and stage I hypertension (93.1 % in both cases). Obesity and overweight were identified in 46.4 % and 37.2 % of patients, respectively. Elevated total cholesterol (>4.9 mmol/L) was observed in 53.4 % of patients, and low-density lipoprotein cholesterol >3.0 mmol/L in 71.2 %. The predominant ABPM phenotypes were day-time systolic-diastolic hypertension (45.2 %) and day-time isolated systolic hypertension (27.4 %). An increased rate of morning BP surge (systolic and diastolic) was recorded in 91.7 and 97.3 % of patients, respectively. Left ventricular hypertrophy was detected in 6.8 % of patients. Increasing body mass index was associated with unfavorable changes in laboratory and echocardiographic parameters, as well as with higher mean daytime systolic BP.

Conclusions. In young and middle-aged adults, hypertension is associated with a high prevalence of cardiometabolic risk factors, prognostically unfavorable 24-hour BP profile abnormalities, and progressive structural and functional cardiac changes with increasing body weight.

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