State of target organs in young people with high-normal arterial pressure and untreated essential arterial hypertension

Objective of the study was to assess hypertension-mediated organ condition in young people with high normal blood pressure (HNBP) and with hypertension.

Material and methods. The study included 112 patients with HNBP or hypertension, aged 25–44. The glomerular filtration rate (eGFR) was estimated according to the CKD-EPI formula for serum creatinine (eGFRcre) and cystatin C content. Microalbuminuria was established in a daily urine sample. Patients underwent echocardiography and dopplerography examination, duplex scanning of the brachiocephalic arteries.

Results. eGFRCre in the range of 89–60 ml/min/1.73 m2 was observed in 37.1 % patients. There were no cases of a decrease eGFRCre less than 60 ml/min/1.73 m2. Renal hyperfiltration (eGFRcre) was detected in 10.3 % examined persons. eGFR by cystatin C content allowed to determine 23 % (p = 0.02) more cases of decreased renal function within 89-60 ml/min/1.73 m2, than eGFRcre. Also, patients with eGFR less than 60 ml/min/1,73 m2 were identified. Renal hyperfiltration was found to be 2 times more (p = 0.002) in patients with HNBP than in patients with hypertension, and frequency of decreasing eGFR below 60 ml/min/1.73 m2 was 11 % less (p <0.050). Microalbuminuria more than 30 mg/day was detected only in patients with hypertension. It was found concentric remodeling was more common in patients with hypertension (p = 0.02), a concentric type of left ventricular hypertrophy was detected only in patients with hypertension, patients did not differ in the frequency of eccentric left ventricular hypertrophy. Patients with HNBP and arterial hypertension had a comparable frequency of increasing arterial thickness.

Conclusion. Young patients with high normal blood pressure have signs of organ damage, often hyperfiltration and an increase in the thickness of arteries. Revealed changes indicate the need to identify this category of people and develop preventive and/ or therapeutic practices.

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