This Article Full Text Full Text (PDF) CME: Take the course for this article: Circulation: January 16, 2007, Volume 115, Number 2 All Versions of this Article: 115/2/221    most recent CIRCULATIONAHA.106.668921v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager patientINFORMation Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Drukteinis, J. S. Articles by Devereux, R. B. Search for Related Content PubMed PubMed Citation Articles by Drukteinis, J. S. Articles by Devereux, R. B. Pubmed/NCBI databases Medline Plus Health Information High Blood Pressure Related Collections Epidemiology Other hypertension Hypertrophy Obesity Echocardiography

(Circulation. 2007;115:221-227.)
© 2007 American Heart Association, Inc.

Hypertension

Cardiac and Systemic Hemodynamic Characteristics of Hypertension and Prehypertension in Adolescents and Young Adults

The Strong Heart Study

Jennifer S. Drukteinis, MD; Mary J. Roman, MD; Richard R. Fabsitz, PhD; Elisa T. Lee, PhD; Lyle G. Best, MD; Marie Russell, MD; Richard B. Devereux, MD

From the Weill Medical College of Cornell University, New York, NY (J.S.D., M.J.R., R.B.D.); National Heart, Lung, and Blood Institute, Bethesda, Md (R.R.F.); University of Oklahoma Health Sciences Center, Oklahoma City (E.T.L.); Missouri Breaks Industries Research, Inc, Timber Lake, SD (L.G.B.); and MedStar Research Institute, Washington, DC (M.R.).

Correspondence to Richard B. Devereux, MD, Division of Cardiology, Box 222, New York Presbyterian Hospital, 525 E 68th St, New York, NY 10021. E-mail rbdevere{at}med.cornell.edu

Received February 24, 2006; accepted October 11, 2006.

Background— The epidemic of overweight is increasing the prevalence of both prehypertension and early-onset hypertension, but few population-based data exist on their impact on cardiac structure and function in adolescents and young adults.

Methods and Results— We analyzed clinical characteristics, hemodynamic parameters, and left ventricular structure and function in 1940 participants, 14 to 39 years of age, in the Strong Heart Study. Hypertension occurred in 294 participants (15%), who were more often men (70% versus 30%), older (age, 31±7 versus 25±8 years), and more commonly diabetic (23% versus 4.5%; all P<0.001) than their normotensive counterparts. Prehypertension occurred in 675 (35%) of participants with similar trends in gender, age, and diabetes status. After adjustment for covariates, both hypertensive and prehypertensive participants had higher left ventricular wall thickness (0.83 and 0.78 versus 0.72 cm), left ventricular mass (182 and 161 versus 137 g), and relative wall thickness (0.30 and 0.29 versus 0.28 cm) and 3- and 2-fold-higher prevalences of left ventricular hypertrophy than their normotensive counterparts (all P<0.001). Hypertension and prehypertension also were associated with higher mean pulse pressure/stroke volume index (1.24 and 1.15 versus 1.02 mm Hg/mL · m²) and total peripheral resistance index (3027 and 2805 versus 2566 dynes · s · cm^–5 · m²; all P<0.001).

Conclusions— In a population with high prevalences of obesity and diabetes, hypertension and prehypertension are associated with increases in both cardiac output and peripheral resistance index. Despite the young age of participants with hypertension and prehypertension, they had prognostically adverse preclinical cardiovascular disease, including left ventricular hypertrophy and evidence of increased arterial stiffness.

Key Words: echocardiography • hemodynamics • hypertension • hypertrophy • prehypertension

Find additional patient-related information at:

http://www.americanheart.org/presenter.jhtml?identifier=3045243

This article has been cited by other articles:

				M. J. Pletcher, K. Bibbins-Domingo, C. E. Lewis, G. S. Wei, S. Sidney, J. J. Carr, E. Vittinghoff, C. E. McCulloch, and S. B. Hulley Prehypertension during Young Adulthood and Coronary Calcium Later in Life Ann Intern Med, July 15, 2008; 149(2): 91 - 99. [Abstract] [Full Text] [PDF]

				B. Williams The year in hypertension. J. Am. Coll. Cardiol., May 6, 2008; 51(18): 1803 - 1817. [Full Text] [PDF]

				S. Knecht, H. Wersching, H. Lohmann, M. Bruchmann, T. Duning, R. Dziewas, K. Berger, and E. B. Ringelstein High-Normal Blood Pressure Is Associated With Poor Cognitive Performance Hypertension, March 1, 2008; 51(3): 663 - 668. [Abstract] [Full Text] [PDF]