Hypertension defined by the 2017 ACC/AHA guideline is more accurate than 2018 ESC/ESH for detecting early vascular aging in young adults

Abstract

AbstractDetermine the most accurate diagnostic criteria of arterial hypertension (AH) for detecting early vascular aging (EVA) defined by pulse wave velocity (PWV) higher than ≥9.2 m/s.Cross-sectional study of a birth cohort started in 1978/79. The following data were collected between April 6, 2016 and August 31, 2017 from 1775 participants: demographic, anthropometric, office blood pressure (BP) measurement, biochemical risk factors, and PWV. A subsample of 454 participants underwent 24-hour ambulatory BP monitoring. The frequencies of AH, and BP phenotypes were calculated according to both guidelines. BP phenotypes (white-coat hypertension, masked hypertension (MHT), sustained hypertension (SH) and normotension) were correlated with risk factors and subclinical target organ damage after adjustment for confounders by multiple linear regression. Receiver operating characteristic curves were constructed to determine the best BP threshold for detecting EVA.A higher frequency of AH (45.1 vs 18.5%), as well as of SH (40.7 vs 14.8%) and MHT (28.9 vs 25.8%) was identified using the 2017 ACC/AHA criteria comparing with 2018 ESC/ESH. EVA was associated with the higher-risk BP phenotypes (SH and MHT, P <130/80 mm Hg.