Klinicist (Nov 2018)
THE ROLE OF ORTHOSTATIC TEST IN PROGNOSIS OF ARTERIAL HYPERTENSION DEVELOPMENT IN YOUNG ADULTS
Abstract
The aim of this study was to assess the role of orthostatic test in prognosis of arterial hypertension (AH) in young adults.Materials and methods. 842 young adults 20–29 years old with the level of blood pressure (BP) <140/90 mm Hg were enrolled in a prospective study. Active orthostatic test was performed. Observation period was 5 years. After that 2 groups were assigned according to BP level: group 1 – with AH (BP level >140/90 mm Hg), group 2 – with normal BP level (<140/90 mm Hg).Results. Physiological type of orthostatic reaction was found in 542 persons (64.4 %), primary hypersympathicotonic type – in 79 (9.4 %), secondary hypersympathicotonic – in 93 (11.1 %), hyposympathicotonic – in 94 (11.2 %), sympathicoasthenic – in 34 (4.0 %). 78 persons were withdrawn from the study for different reasons during observation period. AH was diagnosed in 144 (18.8 %) persons (group 1), normal BP – in 620 (81.2 %) participants (group 2). In group 1 hypersympathicotonic response to orthostatic test was observed in 102 (70.8 %) persons, in group 2 – in 47 (7.6 %) participants (р <0,001). By the results of univariate logistic regression analysis male sex (OR 10.8; 95 % CI 7.6–15.3), body mass index >25 kg/m2 (OR 7.2; 95 % CI 5.7–9.1), smoking (OR 5.6; 95 % CI 4.5–7.0), high normal BP (OR 10.7; 95 % CI 6.9–14.5) and hypersympathicotonic orthostatic response (OR 13.6; 95 % CI 10.0–18.7) were significant risk factors of AH. By the results of multivariate analysis body mass index >25 kg/m2, high normal BP and hypersympathicotonic orthostatic response were independent risk factors.Conclusion. Hypersympathicotonic orthostatic response with increased body mass index and high normal BP are the risk factors of AH development during next 5 years in young adults. It is reasonable to use orthostatic test in assessing the risk of AH development in young people.
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