Aortic Pressure in Different Phenotypes of Hypertension in Young Women, Taking Into Account Their Body Weight

To assess central arterial pressure (CAP) in young overweight women accounting for their arterial hypertension (AH) phenotype derived from 24-hour ambulatory blood pressure monitoring (ABPM) data.

The study included 145 women aged 18 to 35 years with excess (n=104) and normal (n=41) body weight (BW). All subjects underwent office blood pressure (BP) measurement and ABPM with an oscillometric sensor using a BPLab Vasotens device (Petr Telegin LLC, Nizhny Novgorod) with an additional diagnostic option for determining CAP. Group 1 consisted of normotensive women with normal body weight (n=41). Among women with overweight and obesity, the following comparison groups were formed based on ABPM results: Group 2, sustained normotension (n=30), Group 3, "white coat" hypertension (WCH, n=10), Group 4, masked hypertension (n=32), and Group 5, sustained AH (n=32). CAP was evaluated in these groups, including Group 1 of age-matched normotensives with normal body weight. This allowed identifying the following conditions: sustained combined normotension; isolated peripheral hypertension; isolated central hypertension (CH); combined CH with office AH; combined CH with ambulatory AH; and sustained combined hypertension.

CH was detected in almost 10% of Group 1 normotensive women with normal body weight. In normotensive women but with overweight and obesity (Group 2), CH was found in almost half of the examined subjects. Elevated CAP incidence in overweight and obese young women varied by ABPM phenotype of AH appearing in practically a third of WCH cases, and nearly all cases of masked or sustained AH. In our sample, CH was detected in 2 out of 3 overweight women. Analysis of the prevalence of AH hemodynamic variants showed that among the examined women with and without overweight, women with isolated CH (comprising 13% of the cohort) were predominantly overweight (78%). Correlation analysis indicated that increased BMI and waist circumference significantly influenced intra-aortic pressure, linking metabolic risk factors with central and peripheral hemodynamicsConclusion: For young women with overweight or obesity, preventive strategies should include, in addition to measuring office and ambulatory BP, wider implementation of CAP assessment, even if they are initially normotensive, due to their high risk of elevated aortic pressure, despite their young age. Furthermore, CH may affect roughly 10% of normotensive, normal-weight peers. Consequently, this prevalence should be addressed during management of this patient group within primary healthcare settings, including health centers, student polyclinics, and prevention departments (offices).