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REFLECTIONS
Hypertension
Hypertension Global Newsletter #4 2023

prescribed medications was also similar in the two groups. among older men an invitation to undergo comprehensive CV
screening did not significantly reduce the incidence of death of
Hypertension
By design, the trial assessed the effect of being invited to any course at more than five years, a longer-term follow-up may
undergo screening rather than the effects of actual screening. be needed.
However, only 62% of invited men underwent screening;
therefore, the results may underestimate the effects of actual
screening. The men who agreed to screening may be those who
are already interested in maintaining health (healthy user bias)
and therefore may not be representative of the entire population.
The challenge may be in convincing those at highest risk (due
to unidentified/ untreated hypertension, dyslipidaemia, diabetes,
etc.) to undergo screening.

Results of subgroup analyses suggest the possibility of a
greater benefit of screening among participants in the younger
age group (65 to 69 years of age). However, this subgroup was
one of the multiple subgroups assessed, without adjustment for WATCH A QUICK TAKE VIDEO SUMMARY
multiplicity, and further study is needed to confirm the results. It OF THE ARTICLE HERE (1 MIN 46 SEC).
remains unclear whether these results would apply to women,
other age groups, non-white persons, or persons living in
countries with different health-care systems.
CLICK HERE
The current follow-up was a median of 5.6 years, but the trial FOR THE LINK TO FULL ARTICLE
was powered based on a planned 10 years of follow-up. While

PATHOPHYSIOLOGY

Arterial stiffness precedes hypertension and metabolic risks in youth: A review.
Agbaje AO. J Hypertens. 2022 Oct 1;40(10):1887-1896.

Arterial stiffness is a strong predictor of CV events and
mortality in middle-aged and older adults. Preventing or
decreasing arterial stiffness in adolescence may provide
cardiometabolic health benefits later in life. This review article
summarizes recent epidemiological evidence in the adolescent
population supporting the value of arterial stiffness as a novel
risk factor for hypertension, overweight/obesity, and insulin
resistance. It also offers suggestions for incorporating arterial
stiffness measures into routine paediatric and young adult
clinical practice.

Arterial stiffness increases with age across the life course and
excessive stiffening could lead to early organ dysfunction and
damage. Higher arterial stiffness in early life may result from
maternal smoking habits, early life smoking patterns, high salt
intake, genetic programming, obesity, elevated blood pressure,
and other poor cardiometabolic and lifestyle factors.

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