title: Masked hypertension and its associated cardiovascular risk in young individuals: the African-PREDICT study.
abstract: Hypertension prevalence is increasing globally, yet little is known about the occurrence of masked hypertension (MHT) in young, sub-Saharan African adults, and how it relates to elevated cardiovascular risk. The African-PREDICT study (recruitment based on normotensive clinic blood pressure (BP)) determined the frequency of MHT and its relationship with arterial stiffness and biochemical markers of inflammation and endothelial activation. We included men and women (n=352), 20-30 years, screened for normotensive clinic BP (54% white, 40% men). Clinic BP, ambulatory blood pressure monitoring (ABPM), central systolic pressure, aortic pulse wave velocity (aPWV), augmentation index, anthropometry, physical activity and biochemical markers of cardiovascular risk were assessed (lipids, glucose, insulin, markers of endothelial activation and inflammation). Eighteen percent of the study population had MHT (60% white, 68% men). Those with MHT had increased adiposity, clinic-, ABPM- (24-h, day and night) and central-BP (within normal ranges), heart rate, aPWV and biochemical markers of cardiovascular risk, compared with normotensives (all P<0.05). Using multivariable adjusted odds ratios, we found that MHT was associated with increased likelihood for higher aPWV (odds ratio (OR)=1.567, P=0.010), insulin (OR=1.499, P=0.049), monocyte chemoattractant protein-1 (OR=1.499, P=0.026), vascular cellular adhesion molecule (OR=1.409, P=0.042) and C-reactive protein (OR=1.440, P=0.044). In a young adult (supposedly healthy) cohort, the occurrence of MHT is alarming, especially since MHT further demonstrated elevated cardiovascular risk via increased adiposity, arterial stiffness, endothelial activation and inflammation. Detection of MHT is crucial to increase awareness of elevated cardiovascular risk, and to ensure the required lifestyle and/or pharmaceutical interventions.
authors.affiliation: Hypertension in Africa Research Team, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa.
authors.forename: Jane E S
authors.initials: JE
authors.lastname: Thompson
authors.affiliation: Hypertension in Africa Research Team, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa.
authors.forename: Wayne
authors.initials: W
authors.lastname: Smith
authors.affiliation: Hypertension in Africa Research Team, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa.
authors.forename: Lisa J
authors.initials: LJ
authors.lastname: Ware
authors.affiliation: Hypertension in Africa Research Team, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa.
authors.forename: Carina
authors.initials: C
authors.lastname: M C Mels
authors.affiliation: Hypertension in Africa Research Team, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa.
authors.forename: Johannes M
authors.initials: JM
authors.lastname: van Rooyen
authors.affiliation: Hypertension in Africa Research Team, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa.
authors.forename: Hugo W
authors.initials: HW
authors.lastname: Huisman
authors.affiliation: Hypertension in Africa Research Team, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa.|MRC Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa.
authors.forename: Leone
authors.initials: L
authors.lastname: Malan
authors.affiliation: Hypertension in Africa Research Team, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa.
authors.forename: Nico T
authors.initials: NT
authors.lastname: Malan
authors.affiliation: Hypertension in Africa Research Team, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa.
authors.forename: Leandi
authors.initials: L
authors.lastname: Lammertyn
authors.affiliation: Hypertension in Africa Research Team, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa.|MRC Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa.
authors.forename: Aletta E
authors.initials: AE
authors.lastname: Schutte
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood*; D001794:Blood Pressure; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D059468:Masked Hypertension / Q000097:blood* / Q000453:epidemiology / Q000503:physiopathology; D063177:Pulse Wave Analysis; D013019:South Africa / Q000453:epidemiology; D055815:Young Adult
chemical_list: D015415:Biomarkers