The central hemodynamic characteristics of young adults with isolated systolic hypertension (ISH) remain controversial, particularly regarding the extent of pulse pressure amplification (PPamp) compared with that of normotensives (NTs). Given the lack of ambulatory blood pressure monitoring (ABPM)-based data, this study evaluated 509 untreated young adults (18–35 years) who had undergone ABPM during the last decade, 109 who had undergone both ABPM and SphygmoCor analysis, and 26 newly recruited NTs. The agreement rate between office BP- and ABPM-based subtype classification was alarmingly low (50.7%). ISH was distinguishable from systolic–diastolic hypertension, the predominant subtype characterized by increased central BPs and stiffened arteries. The central hemodynamic parameters were all similar between patients with ISH and white-coat hypertension (WC). ISH patients had central BPs that were, albeit higher than those of NTs, at an upper-normal level that was comparable to those of WC patients. ISH patients had similar cfPWV but significantly higher PPamp than NTs ( p = 0.032). The central hemodynamic parameters of the participants were further analyzed according to central pressure waveform types (A vs. B vs. C). Type C waves were associated with the highest PPamp and lowest cfPWV, whereas type A waves were associated with the lowest PPamp and highest cfPWV. Subjects with type B waves, an intermediate form, also had considerably high PPamps. Waveform composition differed significantly across hypertension subtypes ( p < 0.001). ISH patients mostly had type B or C waves (96.7%), with only 3.3% having type A waves. This study based on a refined diagnosis showed that the ambulatory ISH of young adults arises from highly elastic arteries and related robustness of PPamp and shares similar central hemodynamic characteristics with WC patients.

中文翻译：

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年轻成人单纯收缩期高血压的中心血流动力学特征：基于真实世界临床患者动态血压监测的研究

患有孤立性收缩期高血压 (ISH) 的年轻成人的中心血流动力学特征仍然存在争议，特别是与正常血压 (NTs) 相比脉压放大 (PPamp) 的程度。鉴于缺乏基于动态血压监测 (ABPM) 的数据，本研究评估了 509 名在过去十年中接受过 ABPM 的未经治疗的年轻人（18-35 岁）、109 名同时接受了 ABPM 和 SphygmoCor 分析的患者以及 26 名新近招募NT。基于诊室 BP 和 ABPM 的亚型分类之间的一致率低得惊人（50.7%）。ISH 与收缩期 - 舒张期高血压不同，后者是主要亚型，其特征是中央血压升高和动脉硬化。ISH 和白大衣高血压 (WC) 患者的中心血流动力学参数都相似。ISH 患者的中心血压虽然高于 NT，但处于正常上限，与 WC 患者相当。ISH 患者具有相似的 cfPWV，但 PPamp 显着高于 NT（p = 0.032）。根据中心压力波形类型（A vs. B vs. C）进一步分析参与者的中心血流动力学参数。C 型波与最高 PPamp 和最低 cfPWV 相关，而 A 型波与最低 PPamp 和最高 cfPWV 相关。具有 B 型波（一种中间形式）的受试者也具有相当高的 PPamps。不同高血压亚型的波形组成存在显着差异（p < 0.001）。ISH 患者多为 B 型或 C 型波（96.7%），只有 3.3% 的人是 A 型浪。这项基于精确诊断的研究表明，年轻成人的动态 ISH 源于高弹性动脉和 PPamp 的相关稳健性，并且与 WC 患者具有相似的中心血流动力学特征。