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Masked hypertension frequency in a population of young adults: risk factors and association with subclinical target organ damage

Grant number: 19/20171-0
Support type:Scholarships in Brazil - Scientific Initiation
Effective date (Start): January 01, 2020
Effective date (End): December 31, 2020
Field of knowledge:Health Sciences - Medicine
Principal Investigator:Eduardo Barbosa Coelho
Grantee:Mariana Passos de Souza
Home Institution: Faculdade de Medicina de Ribeirão Preto (FMRP). Universidade de São Paulo (USP). Ribeirão Preto , SP, Brazil

Abstract

Hypertension (H) is considered the main modifiable cardiovascular risk factor. Phenotypes based on blood pressure (BP) can be obtained comparing office-BP measurements (OBP) with 24hrs Ambulatory Blood Pressure Monitoring (ABPM). Among them, masked hypertension (MH) is characterized as normal OBP and ABPM with abnormal values. MH is associated with target organ damage and cardiovascular outcomes in adults over 50 years old. The goal of the project is to determinate MH frequency, its main risk factors, and association with subclinical target organ damage in a sample of young adults. From the original cohort created in Ribeirão Preto in 1978/79, with originally 6827 participants, 1775 were reevaluated in 2017, being part of this study. OBP was done according to VI Brazilian Hypertension Guideline with semi-automatic equipment Omron 742INT. ABPM (Cardios, Dynamapa) was obtained with measurements every 15 minutes on day-time and 30 in the nighttime. Phenotypes will be obtained based on threshold values from VII Brazilian Hypertension Guideline and with American Heart Association/American College of Cardiology (2017 ACC/AHA) and will be compared. Blood samples were collected and used to quantify creatinine, cystatin C, HbA1c, cholesterol, HDL and triglycerides, and also urine for microalbuminuria. Clinical data such as the use of antihypertensive, history of hypertension, diabetes or smoking, measurements of weight, height and waist were also obtained. Glomerular Filtration Rate will be estimated by CKD-EPI 2019 formula and the cardiovascular risk by the equation provided in AHA/ACC 2017. The pulse wave velocity (PWV, Atcor, sphygmocor) will be used to measure subclinical vascular damage. Data will be analyzed by ANOVA, linear or logistic regression models using SAS software.