Is Isolated Diastolic Hypertension an Important Phenotype?

Romero, César A; Tabares, Aldo; Orías, Marcelo

doi:10.1007/s11886-021-01609-w

Cited by 14 publications

(12 citation statements)

References 48 publications

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“…Isolated diastolic hypertension (IDH) is a hypertension phenotype characterized by an SBP <140 mmHg and a DBP >90 mmHg. In the general adult population, IDH prevalence has been reported to be between 2.5 and 7.8% [875,876], with a peak between 30 and 39 years, a decrease in the fifth and sixth decades and almost no case above 70 years of age [877]. IDH has a greater prevalence in men than in women [875].…”

Section: Isolated Diastolic Hypertensionmentioning

confidence: 99%

2023 ESH Guidelines for the management of arterial hypertension The Task Force for the management of arterial hypertension of the European Society of Hypertension

Chairperson

Co-Chair

Brunström

et al. 2023

Journal of Hypertension

1,136

280

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Document Reviewers: Luis Alcocer (Mexico), Christina Antza (Greece), Mustafa Arici (Turkey), Eduardo Barbosa (Brazil), Adel Berbari (Lebanon), Luís Bronze (Portugal), John Chalmers (Australia), Tine De Backer (Belgium), Alejandro de la Sierra (Spain), Kyriakos Dimitriadis (Greece), Dorota Drozdz (Poland), Béatrice Duly-Bouhanick (France), Brent M. Egan (USA), Serap Erdine (Turkey), Claudio Ferri (Italy), Slavomira Filipova (Slovak Republic), Anthony Heagerty (UK), Michael Hecht Olsen (Denmark), Dagmara Hering (Poland), Sang Hyun Ihm (South Korea), Uday Jadhav (India), Manolis Kallistratos (Greece), Kazuomi Kario (Japan), Vasilios Kotsis (Greece), Adi Leiba (Israel), Patricio López-Jaramillo (Colombia), Hans-Peter Marti (Norway), Terry McCormack (UK), Paolo Mulatero (Italy), Dike B. Ojji (Nigeria), Sungha Park (South Korea), Priit Pauklin (Estonia), Sabine Perl (Austria), Arman Postadzhian (Bulgaria), Aleksander Prejbisz (Poland), Venkata Ram (India), Ramiro Sanchez (Argentina), Markus Schlaich (Australia), Alta Schutte (Australia), Cristina Sierra (Spain), Sekib Sokolovic (Bosnia and Herzegovina), Jonas Spaak (Sweden), Dimitrios Terentes-Printzios (Greece), Bruno Trimarco (Italy), Thomas Unger (The Netherlands), Bert-Jan van den Born (The Netherlands), Anna Vachulova (Slovak Republic), Agostino Virdis (Italy), Jiguang Wang (China), Ulrich Wenzel (Germany), Paul Whelton (USA), Jiri Widimsky (Czech Republic), Jacek Wolf (Poland), Grégoire Wuerzner (Switzerland), Eugene Yang (USA), Yuqing Zhang (China).

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Section: Isolated Diastolic Hypertensionmentioning

confidence: 99%

2023 ESH Guidelines for the management of arterial hypertension The Task Force for the management of arterial hypertension of the European Society of Hypertension

Chairperson

Co-Chair

Brunström

et al. 2023

Journal of Hypertension

1,136

280

View full text Add to dashboard Cite

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“…Similarly, the MOnica, Risk, Genetics, Archiving, and Monograph Project, a cohort study with 68,551 participants without cardiovascular disease, showed that the HR for DBP decreased with age (p < .001) and was not influenced by other cardiovascular risk factors 20 . Isolated diastolic hypertension constitutes the most frequent phenotype in hypertensive individuals aged <50 years 32 . Age‐dependent development of arterial stiffening results in a higher SBP in older individuals 19 .…”

Section: Discussionmentioning

confidence: 97%

“…6,11 Current cardiovascular risk estimation tools 13 and hypertension guidelines 14 20 Isolated diastolic hypertension constitutes the most frequent phenotype in hypertensive individuals aged <50 years. 32 Age-dependent development of arterial stiffening results in a higher SBP in older individuals. 19 Compared to older individuals, younger people have a low cardiovascular risk.…”

Section: Discussionmentioning

confidence: 99%

Associations of blood pressure components with risks of cardiovascular events and all‐cause death in a Chinese population: A Prospective Study

Zhang

Tang

et al. 2022

J of Clinical Hypertension

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The associations of blood pressure components with cardiovascular risks and death remain unclear, and the definition of wide pulse pressure (PP) is still controversial. Using data from 1257 participants without a history of cardiovascular disease, who were followed for 4.84 years, we performed multivariable Cox regression analyses to assess how systolic blood pressure (SBP), diastolic blood pressure (DBP), and PP contribute to risks of cardiovascular events and all‐cause death. Among all participants, SBP and PP were significantly associated with the risks of cardiovascular events and all‐cause death (all p < .05). DBP was not significantly associated with the risk of all‐cause death; rather, it was only associated with a marginally significant 1% increased risk for cardiovascular events (p = 0.051). In participants aged < 65 years, DBP was significantly associated with a 3% increased risk for cardiovascular events (hazard ratio [HR]: 1.03, 95% confidence interval [95% CI]: 1.01–1.06). The association between PP and cardiovascular events appeared to be J‐shaped in comparison to participants with the lowest‐risk PP (50–60 mmHg), with adjusted HRs of 1.71 (95% CI: 1.03–2.85), 1.63 (95% CI: 1.00–2.68), and 2.13 (95% CI: 1.32–3.43) in the <50, 60.0–72.5, and ≥72.5 mmHg subgroups, respectively. The optimal cutoff points of a wide PP for predicting the risks of cardiovascular events and all‐cause death were 70.25 and 76.25 mmHg, respectively. SBP and PP had a greater effect on cardiovascular risk, whereas DBP independently influenced cardiovascular events in middle‐aged participants. Considerable PP alterations should be avoided in antihypertensive treatment.

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“…However, we only found significant correlations with diastolic blood pressure and not systolic blood pressure. While systolic blood pressure results from the cardiac output and vessel mechanical properties, diastolic blood pressure, which is coupled with the relaxing or filling cardiac phase of the cardiac cycle, is a consequence of potential energy accumulated in the vessel due to the elastic components of the vessel [ 44 ]. In essential hypertension, isolated diastolic hypertension is associated with a different hemodynamic profile than hypertension with elevation in both systolic and diastolic blood pressure [ 44 ].…”

Section: Discussionmentioning

confidence: 99%

“…While systolic blood pressure results from the cardiac output and vessel mechanical properties, diastolic blood pressure, which is coupled with the relaxing or filling cardiac phase of the cardiac cycle, is a consequence of potential energy accumulated in the vessel due to the elastic components of the vessel [ 44 ]. In essential hypertension, isolated diastolic hypertension is associated with a different hemodynamic profile than hypertension with elevation in both systolic and diastolic blood pressure [ 44 ]. It is unknown if, in hemodialysis patients, the response of diastolic blood pressure to hypervolemia and to blood volume reduction by ultrafiltration is related to the hemodynamic profile of each patient.…”

Section: Discussionmentioning

confidence: 99%

Correlation between Angiotensin Serum Levels and Very-Low-Frequency Spectral Power of Heart Rate Variability during Hemodialysis

Valle-Mondragón

Becerra-Luna

Cartas-Rosado

et al. 2022

Life

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Cardiovascular regulatory mechanisms that fail to compensate for ultrafiltration and cause hypovolemia during hemodialysis (HD) are not completely understood. This includes the interaction between the autonomic nervous system and the biochemistry that regulates blood pressure and modulates cardiac activity and vascular tone in response to hypovolemia in patients treated with HD. The objective was to evaluate the association of spectral indices of heart rate variability (HRV) with serum levels of angiotensin II, angiotensin 1–7, nitric oxide and total antioxidant capacity during HD. Electrocardiographic records were obtained from 20 patients during HD (3 h), from which HRV data and spectral power data in the very-low-frequency (VLF), low-frequency (LF) and high-frequency (HF) bands were generated. Three blood samples per patient were collected during HD (0.0, 1.5, 3.0 h) to determine the levels of biomarkers involved in the pressor response during HD. Angiotensin II had a positive correlation with VLF (r = 0.390) and with LF/HF (r = 0.359) and a negative correlation with LF (r = −0.262) and HF (r = −0.383). There were no significant correlations between HRV and the other biomarkers. These results suggest that during HD, VLF could reflect the serum levels of angiotensin II, which may be associated with the autonomic response to HD.

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Is Isolated Diastolic Hypertension an Important Phenotype?

Cited by 14 publications

References 48 publications

2023 ESH Guidelines for the management of arterial hypertension The Task Force for the management of arterial hypertension of the European Society of Hypertension

2023 ESH Guidelines for the management of arterial hypertension The Task Force for the management of arterial hypertension of the European Society of Hypertension

Associations of blood pressure components with risks of cardiovascular events and all‐cause death in a Chinese population: A Prospective Study

Correlation between Angiotensin Serum Levels and Very-Low-Frequency Spectral Power of Heart Rate Variability during Hemodialysis

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