EVA syndrome and hypertension in young people according to the work of the University Health Center of the StSMU

Abstract

Relevance. There is still a discussion about what is primary and what is secondary — an increase in blood pressure (BP) or vascular remodeling.Objective. To assess the occurrence of isolated cases of Early Vascular Aging (EVA) syndrome and in combination with arterial hypertension/prehypertension in young people, taking into account body mass (BM) and manifestations of connective tissue insufficiency (CTI).Design and methods. In total, 346 people aged 18 to 25 years (131 boys or 37,9 % and 215 girls or 62,1 %) were examined. At first, the examined persons were divided into tercile-groups according to the indicator of vascular stiffness (VS) — the cardio-ankle vascular index (CAVI) (VaSera VS-1500N, Fucuda Denshia, Japan). VS is regarded as the main determinant of vascular aging. The upper CAVI-tercile of this distribution among persons of the same sex and age corresponds to the EVA-syndrome. The first tercile corresponds to the favorable and the average one corresponds to normal vascular aging. Then the association of these aging phenotypes with the level of BP, BM and the severity of signs of CTI was analyzed. The control group comprised normotonic representatives of the first and second CAVI-tercile groups. Data processing was carried out using the software package “Statistica 10.0” (StatSoftInc, USA).Results. In boys and girls, the incidence of isolated increases in VS is 16,8 % and 26,5 %, in combination with increased BP — 17,6 % and 6,5 %, isolated increases in BP — 39,6 % and 14,0 %, and normotension in combination with preserved elastic potential — 26,0 % and 53,0 %. Among normotonic boys and girls of isolated elevated VS, persons with excessive BM accounted for 14,8 % and 4,9 %, and with insufficient BM — 48,2 % and 29,5 %, respectively. The latter persons were characterized by a significantly higher number of signs of CTI compared to the control. And among the boys and girls of increased BP without an increase in VS, on the contrary, persons with excess BM and obesity are prevalent.Conclusions. Among young people, cases of increased VS are not always combined with such traditional risk factors as high BP and obesity, which is due to the so-called youth “obesity paradox”, as well as CTI. In preventive examinations of young people, differential diagnosis of the true EVA-syndrome with CTI should be performed, in the latter VS may increase due to the development of dysplastic-associated angiopathy. It is essential for the correct selection of cardio-vascular risk groups and further individualized preventive interventions among young people.