[Spurious hypertension in an athletic young man].

Area of Science:

• Cardiology
• Hypertension Research
• Vascular Physiology

Background:

• Isolated systolic hypertension (ISH) is common in the elderly but can occur in younger adults.
• Increased pulse wave amplification can cause discrepancies between central and peripheral blood pressure measurements.
• Younger individuals with ISH may present without secondary hypertension or organ damage.

Purpose of the Study:

• To investigate the cause of isolated systolic hypertension in a young, athletic adult.
• To determine if the elevated peripheral blood pressure reflects true hypertension or pseudohypertension.
• To highlight the importance of central blood pressure measurement in specific patient populations.

Main Methods:

• Patient presentation: A 21-year-old athletic male with arterial blood pressure of 160/85 mmHg.
• Diagnostic work-up: Excluded secondary hypertension and organ damage (e.g., left ventricular hypertrophy, microalbuminuria).
• Pulse wave analysis: Utilized arterial tonometry to measure central aortic systolic blood pressure.

Main Results:

• Diagnostic work-up revealed no evidence of secondary hypertension or target organ damage.
• Pulse wave analysis demonstrated a 29 mmHg lower central systolic blood pressure compared to brachial artery pressure.
• This significant difference indicated pseudohypertension.

Conclusions:

• Isolated systolic hypertension in athletic young adults can be a manifestation of pseudohypertension.
• A discrepancy between brachial and central blood pressure measurements is crucial for accurate diagnosis.
• Pulse wave analysis is a valuable tool for identifying pseudohypertension in cases of apparent ISH.