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Novel hypertension phenotypes based on cross-classification of 24-h brachial and aortic SBP
Journal article   Peer reviewed

Novel hypertension phenotypes based on cross-classification of 24-h brachial and aortic SBP

Elpida Athanasopoulou, Thomas Weber, James E Sharman, Siegfried Wassertheurer, Mohsen Agharazii, Antonios Argyris, Sola Aoun Bahous, Jose R Banegas, Ronald K Binder, Jacques Blacher, …
Journal of hypertension
06/16/2026
DOI: 10.1097/HJH.0000000000004376
PMID: 42299866

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Abstract

Novel hypertension phenotypes are described by cross-classification of brachial and aortic SBP (brSBP/aoSBP). The aim of this study is to examine their prevalence and age and sex-distribution, factors that potentially modulate them, and their association with left ventricular hypertrophy (LVH). Data on 24-h ambulatory BP monitoring (ABPM) using the Mobilograph device (IEM GmbH, Stolberg, Germany) and LVH from the International 24-h Ambulatory aortic Blood pressure Consortium (i24ABC) were retrieved from 31 centers (17 countries). The population was categorized into four phenotypes; concordant systolic normotension (CSN: both SBPs normal), isolated brachial systolic hypertension (IbrSH: high brSBP/normal aoSBP), isolated aortic systolic hypertension (IaoSH: normal brSBP/high aoSBP), and concordant systolic hypertension (CSH: both SBPs high). In 8738 participants (age: 58.4 ± 15.1 years; 51.8% men), the prevalence of IaoSH was 7.7%, being more prevalent in men, and presenting a U-shape age-distribution in them compared to a linear distribution in females. IaoSH was associated with lower heart rate and beta-blockade medications. The prevalence of IbrSH was 6.5%, presenting an inverted U-shape age-distribution; it was higher in the presence of higher heart rate and calcium channel-blockade. In 2307 individuals with LVH data, after adjustment for age, sex, DBP, IaoSH - but not IbrSH - had 2.6 higher odds of LVH compared to CSN (95% confidence interval, 1.7-3.9) and similar to CSH. IaoSH and IbrSH amounted to almost 15% and showed specific clinic characteristics. Only IaoSH was significantly associated with LVH. Outcome-driven randomized controlled trials are needed to further investigate their clinical relevance.
 Cardiovascular Disease ABPM chronic kidney disease aortic SBP brSBP brachial SBP brachial Blood Pressure BP CCBs Breton international 24-hour Ambulatory aortic Blood pressure Consortium ASE IDCARS hypertension-mediated organ damage CSH SAFAR Concordant Systolic Normotension IbrSH CKD aortic CSN Isolated brachial Systolic Hypertension blood pressure Left Ventricular Mass index LVMi aortic blood pressure Calcium Chanel Blockers Concordant Systolic Hypertension Left Ventricular Hypertrophy Mean Arterial Pressure ao CVD ambulatory blood pressure monitoring brBP IMT Isolated aortic Systolic Hypertension i24ABC intima-media thickness study, non-invaSive Aortic ambulatory blood pressure monitoring For the detection of tARrget organ damage study International Database of Central Arterial Properties for Risk Stratification blood pressure phenotypes aoSBP HMOD American Society of Echocardiography MAP brachial IaoSH LVH

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