title: Clinical characteristics of young-onset and medical treatment-requiring hypertension identified by targeted screening in university health check-up.
abstract: Based on targeted screening for hypertension at a university health check-up, we previously reported a high incidence of white-coat hypertension and estimated prevalence of hypertension requiring medical treatments (HT) as around 0.1% in young population aged less than 30. In spite of such low prevalence, continuous screening for seven consecutive years (2003-2009) increased the number of HT students to 20 (19 males and 1 female). We presently assessed the clinical characteristics of these HTs. Renovascular hypertension was found in the only female HT and aortic valve regurgitation in two HTs. Resting 17 HTs were diagnosed as having essential hypertension (EH). A father and/or a mother had EH in 16 out of 17 EHs, and blood pressure (BP) at home was slightly elevated (135-145 mm Hg in systolic) except three obese EHs (body mass index more than 30) who demonstrated more than 160 mm Hg in systolic. Plasma aldosterone-renin ratio (ARR) of EHs did not differ from that of normal controls, and Pearson correlation coefficient (R) between ARR and systolic BP (SBP) was -0.2. Its partial correlation coefficient, however, was statistically significant (R = -0.55, P = .026) after correcting for body mass index, which was significantly correlated with both SBP (P = .006, after correcting for ARR) and ARR (P = .004, after correcting for SBP). In conclusion, most of young-onset HTs are male EHs, and aortic valve regurgitation should be carefully checked. Excess plasma renin activity would be one of additional characteristics of young-onset EH to male gender, genetic background, and increased body mass.
authors.affiliation: Division of Molecular Medicine, Tohoku University School of Medicine, Sendai, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Endo
authors.forename: Fukashi
authors.initials: F
authors.lastname: Serizawa
authors.forename: Takumi
authors.initials: T
authors.lastname: Kato
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Toyama
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Ejima
authors.forename: Akira
authors.initials: A
authors.lastname: Sato
authors.forename: Shin
authors.initials: S
authors.lastname: Kurosawa
authors.forename: Yoko
authors.initials: Y
authors.lastname: Hasegawa
authors.forename: Wataru
authors.initials: W
authors.lastname: Hida
authors.forename: Mitsunobu
authors.initials: M
authors.lastname: Matsubara
mesh_terms: D000328:Adult; D017668:Age of Onset; D000450:Aldosterone / Q000097:blood; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001022:Aortic Valve Insufficiency / Q000453:epidemiology; D018660:Blood Pressure Monitoring, Ambulatory / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D006977:Hypertension, Renal / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D007564:Japan / Q000453:epidemiology; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data; D012083:Renin / Q000097:blood; D012307:Risk Factors; D017678:Sex Distribution; D013333:Student Health Services / Q000706:statistics & numerical data*; D013334:Students / Q000706:statistics & numerical data*; D059466:White Coat Hypertension / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000959:Antihypertensive Agents; D000450:Aldosterone; D012083:Renin