ArticleJournal of the American Heart Association2025
Phenotypes of Hypertension: Impact of Age and Sex on Hemodynamic Mechanisms.
Article in Journal of the American Heart Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Associations of transitions in frailty and depressive symptoms with the risk of cardiovascular disease in adults with hypertension: findings from three aging cohorts.The journal of nutrition, health & aging · 2026Article
- Clinical Risk Factors Differ by Sex for Kidney Complications but Not Retinopathy in Type 1 Diabetes: The Pittsburgh Epidemiology of Diabetes Complications Cohort.Diabetes care · 2026Article
- Development and Temporal Validation of a Multinomial Prediction Model for Phenotypes of Undiagnosed Hypertension in Peru: A Population-Based Study.Medical sciences (Basel, Switzerland) · 2026Article
- The High Prevalence of High Normal Blood Pressure and the Differential Association of Grip Strength Metrics with Hypertension in a National Sample of Chinese College Students.Journal of clinical medicine · 2026Article
- The insulin resistance-systemic vascular resistance-isolated diastolic hypertension axis: a metabolic framework for an overlooked hypertension phenotype.Frontiers in cardiovascular medicine · 2026Review
- Exercise-induced hypertension, leukocyte telomere length, and dietary antioxidant intake in elite male taekwondo athletes: an integrated analysis.Frontiers in physiology · 2026Article
Corrections and comments
- Erratum issued
Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEssential hypertension is often treated as a uniform condition. However, it encompasses distinct patterns of blood pressure elevation such as isolated systolic, systolic diastolic, and isolated diastolic hypertension, which vary in prevalence according to age and sex. We hypothesized that different hemodynamic mechanisms account for the age- and sex-related differences in these hypertensive phenotypes.
methodsIn this cross-sectional analysis of the ACCT (Anglo-Cardiff Collaborative Trial), 5371 individuals (2402 male), aged 18 to 92 years, free of cardiovascular disease and medication were included. Blood pressure, cardiac output, stroke volume, peripheral vascular resistance (PVR), and aortic pulse wave velocity were measured. Within each sex, subjects were stratified according to age (<30, 30-60, and >60 years), and blood pressure phenotype based on clinic (seated) blood pressure.
resultsIsolated systolic hypertension was the most common hypertensive phenotype in young men and characterized by an elevated cardiac output and stroke volume. In contrast, systolic diastolic hypertension and isolated diastolic hypertension were more common in younger females, with systolic diastolic hypertension associated with elevated PVR and aortic pulse wave velocity, and isolated diastolic hypertension with increased PVR. Systolic diastolic hypertension was the most common phenotype in middle age and accompanied by increased PVR in both sexes. Isolated systolic hypertension was again the most common phenotype in older individuals. However, in contrast to younger adults, isolated systolic hypertension affected both men and women equally (~1:1) and was characterized by elevated aortic pulse wave velocity and PVR.
conclusionsDifferent hypertensive phenotypes are characterized by distinct hemodynamic mechanisms in an age- and sex-dependent manner. Targeting therapy toward primary hemodynamic abnormalities could lead to more effective interventions in essential hypertension.
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