Arterial stiffness and pulse pressure amplification in adults with isolated systolic hypertension

Background/aim: ISH is usually considered more prevalent in aged individuals and associated to increased large artery stiffness. This study is aimed at identifying determinants of ISH in adult individuals. Methods: 20 individuals <60 years, referred to the Outpatient Hypertension Unit for high blood pressure (BP) and treatment-naïve, were classified as normotensive (NT), true hypertensives (HT) or isolated systolic hypertensives (ISH) based on office BP. In all individuals the following measurements were obtained: carotid pulse wave velocity (PWV) and aortic BP by applanation tonometry (Sphygmocor CVP, Atcor), 24-h brachial and central BP (Oscar2, SunTech Medical), daily steps by 7-day actigraphy (Fitbit Flex). Results: the tree groups had similar clinical characteristics, including height and physical activity; only waist circumference was higher in ISH. PWV was normal in ISH and increased in HT. Office brachial and aortic pulse pressure (PP) were greater in ISH than in NT and HT, as well as 24-h brachial and central PP. PP amplification was similar in the three groups either when calculated by tonometry or in 24h. ISH (n = 7) NT (n = 7) HT (n = 6) Men 5 5 4 Age (years) 43±15 47±10 41±10 Height (cm) 174±10 171±11 174±11 BMI (kg/mq) 26±2 25±2 24±3 Waist circumference (cm) 93±13* 81±11 81±9 Physical activity (daily steps) 13021±4958 11569±6789 13836±4572 Mean BP (mmHg) 101±9° 90±8 102±13° Heart rate (bpm) 60±6 61±13 53±10 Office PP (mmHg) 62±9*° 48±7 50±7 Aortic PP (mmHg) 45±8*° 38±4 40±6 24h-brachial PP (mmHg) 55±9* 46±9 51±6 24h-central PP (mmHg) 43±4* 37±4 40±4 24h- PP amplification (mmHg) 12±5 9±2 11±3 Time to reflection (ms) 142±15° 143±13* 161±21* PWV (m/s) 6.3±1.4° 7.2±2.5° 8.0±2.2* *:p < 0.05 vs NT; ° p < 0.05 vs HT. Conclusions: These preliminary data suggest that adults <60 years, newly diagnosed with ISH, present normal PWV and PP amplification from centre to periphery.