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Systolic Hypertension in Youth

  • James D. H. Goodman
  • Ian B. Wilkinson
  • Carmel M. McEniery
Chapter
Part of the Updates in Hypertension and Cardiovascular Protection book series (UHCP)

Abstract

Isolated systolic hypertension is defined as systolic blood pressure ≥140 mmHg and diastolic blood pressure <90 mmHg. In older adults, ISH results from an increase in large artery stiffness, and the association with increased cardiovascular risk is well documented. However, ISH is not limited to older individuals—it is now the most frequent hypertension subtype in young adults, especially men, with a rising incidence, driven by population changes in lifestyle and nutrition. Controversy exists on whether ISH in youth is associated with increased cardiovascular risk or is simply a benign condition resulting from exaggerated peripheral pulse pressure amplification of a ‘normal’ central (aortic) blood pressure. A number of pathophysiological mechanisms have been proposed as contributing to ISH in youth, including increased sympathetic drive, with increased cardiac output and stroke volume which result in elevations in both central (aortic) and peripheral (brachial) BP. There is increasing evidence that ISH in young adults is not simply artefactual, but is instead associated with sustained hypertension into later adulthood and subsequent increases in cardiovascular risk. As such, it should be actively managed with lifestyle advice and pharmacological therapy, if indicated.

Keywords

Isolated systolic hypertension Young adults Youth Pulse pressure Central pressure 

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  • James D. H. Goodman
    • 1
  • Ian B. Wilkinson
    • 1
  • Carmel M. McEniery
    • 1
  1. 1.Experimental Medicine and ImmunotherapeuticsUniversity of CambridgeCambridgeUK

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