Arterial hypertension in young adults

Abstract

Arterial hypertension (AH) is associated with the development of pathological changes in target organs, which leads to an increase in morbidity and mortality. The aim of the review was to discuss the peculiarity of AH in young people, in particular risk factors for developing AH, associations between the risk of cardiovascular events and elevated blood pressure in young adults, blood pressure phenotypes in young people, the role of traditional cardiovascular diseases risk factors in young people with AH, features of target organ damages in young people with AH and optimal blood pressure for target organ protection. Threshold values of blood pressure, from which the cycle of pathological changes starts, have not been finally determined, however, it is likely that they are significantly lower than the blood pressure values that are currently used to diagnose AH n in Europe and Russia. Reclassification of AH using more strict criteria in the United States resulted in an increase in the prevalence of AH from 29 % to 43 %, and affected mainly young people. Obesity, increased daily sodium excretion, increased consumption of meat products, dyslipidemia, hyperinsulinemia, hyperuricemia, high levels of depression and low social status are among the potential risk factors for developing AH at a young age, while a low-salt diet, eating a large amount of plant foods, high in carotenoids and folate, and a high level of physical activity may have a preventive effect on the development of AH. The results of recent studies indicate a high prevalence of AH, including masked, in young people, which often remains underestimated in real clinical practice. The strategy for the treatment of AH in young patients has not been determined, which is associated with an insufficient evidence base. Studies are needed to identify additional arguments for initiating or withholding antihypertensive therapy in this population, including the study of early signs of hypertension-associated target organ damage. Conclusion. The results of recent studies indicate a high prevalence of hypertension, including masked, in young people, which often remains underestimated in real clinical practice. Further research is required to identify additional arguments for initiating or withholding antihypertensive therapy in this population, including the study of early signs of hypertension-associated target organ damage.