Scientific Online Resource System

Scripta Scientifica Medica

Risk profile and hemodynamic characteristics in young subjects with high normal arterial blood pressure

Julia Georgieva Nikolova, Mariana Bacelova, Petar Hrischev, Margarita Hadjieva, Petar Nikolov, Daniela Koleva


Introduction: The European Society of Cardiology classifies arterial pressure bellow 140/90 mmHg as optimal (below 120/80 mmHg), normal (120-129 mmHg for systolic and/or 80-84 mmHg for diastolic) and high normal (130-139 mmHg for systolic and/or 85-89 mmHg for diastolic). The argument is concerned with different cardiovascular risk. The possibility for arterial hypertension (AH) to appear is higher in individuals with high normal arterial pressure (HNAP). Such individuals could be treated with non-drug therapy as the idea is the appearance of AH to be delayed and the cardiovascular risk to be reduced.

The goal of the study was to examine the risk and hemodynamic profile of medical students with HNAP.

Material and methods:  The object of the investigation was focused on medical students with HNAP. The two followed-up groups - with HNAP and with optimal arterial blood pressure (OBP) assumed this pattern on the base of inquiry and screening among 116 students (60 men and 56 women). Inquiry and anthropometric methods, arterial pressure monitoring and impedance cardiography were carried out.

Results: The dominance of some factors, predisposing hypertension appearance as overweight, increased salt consumption, family history was registered in HNAP group. Hemodynamic evaluation manifested hyperkinetic type of circulation.

Conclusion: Medical students` risk and hemodynamic profile within HNAP group is close to that of the hypertensive individuals. That makes them a special risk group and there is a necessity of non-drug treatment in order to delay AH expression.


high normal AP; risk factors; impedance cardiography

Full Text


Kaplan N. Kaplan`s Clinical Hypertension. 9th ed. Philadelphia: Lippincott, Williams&Wilkins; 2006.

Reappraisal of European guidelines of hypertension management. Journal of Hypertens. 2009;27(11):2121-2158.

Gupta AK, McGlone M, Greenway FL et al. Prehypertension in disease-free adults: a marker for an adverse cardiometabolic risk profile. Hypertens Res. 2010;33:905-910.

Lee M, Saver J, Chang B et al. Presence of baseline prehypertension and risk of incident stroke - a meta-analysis. Neurology. 2011;77:1330-1.

Conroy RM, Pyörälä K, Fitzgerald AP et al. Estimation of ten-year risk of fatal cardiovascular disease in Europe: the SCORE project. European Heart Journal. 2003;24:987-1003.

Lifon et al. Molecular mechanism of human hypertension. Cell. 2001;104(4):545-556.

FJ, Mac Gregor GA. A comprehensive review on salt and health and current experience of worldwide salt reduction programmes. J Hum Hypertens. 2009;23(6):363-84.

Dickinson HO, Mason JM, Nikolson DJ, Compbell F, BeyerFR, Cook JJ, WilliamsB, Ford GA. Lifestyle interventions to reduce raised blood pressure: a systematic review of randomized controlled trials. J Hypertens. 2006 Feb;24(2):215-33..

Gray DS, Fujioka K. Use of relative weight and Body Mass Index for the determination of adiposity. J Clin Epidemiol. 1991;44(6):545-50.

Berrington de Gonzalez A, Hartge P, Cerhan JR, Flint AJ, Hannan L, MacInnis RJ et al. Body-Mass Index and Mortality among 1.46 Million White Adults. N. Engl. J. Med. 2010;363(23):2211-9.

Koleva D, Mitkov M, Orbetsova M. Screening of obesity as a main risk factor for the development of metabolic syndrome. MedInfo. 2012; 4,7-9. (in Bulgarian)

Dueck R, Jameson LC. Reliability of hypotension detection with noninvasive radial artery beat-to-beat versus upper arm cuff BP monitoring. Anesth Analg. 2006;102Suppl:S10.

Fortin J, Marte W, Grüllenberger R, Hacker A, Habenbacher W, Heller A, et al. Continuous non-invasive blood pressure monitoring using concentrically interlocking control loops. Computers in Biology and Medicine. 2006;36(9):941-57.

Cybulsky G. Ambulatory Impedance Cardiography: The System and their Applications. 2011.

Sanidas EA, Grammatikopoulos K, Anastasiadis G, Papadopoulos D, Daskalaki M, Votteas V. Thoracic fluid content and impedance cardiography: a novel and promising noninvasive method for assessing the hemodynamic effects of diuretics in hypertensive patients. Hellenic J Cardiol. 2009 Nov-Dec;50(6):465-71.

Stevanović P, Šćepanović R , Radovanović D, Bajec D , Perunović R, Stojanović D, Stevanović D. Thoracic electrical bioimpedance theory and clinical possibilities in perioperative medicine. Signa Vitae 2008;3 Suppl 1: S 22-27.

Van De Water JM, Miller TW, Vogel RL, Mount BE, Dalton ML. Impedance cardiography: the next vital sign technology? Chest. 2003;123:2028-33.

Shoemaker WC, Wo CC, Bishop MH, Thangathurai D, Patil RS. Noninvasive hemodynamic monitoring of critical patients in the emergency department. Acad Emerg Med 1996;3:675-81.

Humeau A, Steenbergen W, Nilsson H, Strömberg T, (2007) Laser Doppler perfusion monitoring and imaging: novel approaches. Med. Biol. Eng. Comput. 2007;45:421-435.

Iliev I, Tabakov S. Multichannel wideband measuring of bio-impedance with logarithmic characteristics. Available from:

Measurement%20with%20Logarithmic%20Characteristic.pdf (in Bulgarian)

Petrov G, Tsvetkov P, Iliev P. Non-invasive medical measuring devices. Metrology and metrological provision. Sozopol, 2006. (in Bulgarian)

Biopac MP hardware and software manuals.

Nikolov FP, Nikolov P, Nikolova J. Prevalence and Risk Profile of Prehypertension in South Bulgaria. Conference on PreHypertension & Cardio Metabolic Syndrome. February 24-27, 2011, Vienna, Austria.

Vasan RS, Larson MG, Leip EP et al. Impact of high-normal blood pressure on the risk of cardiovascular disease. N Engl J Med. 2001;345:1291-7.

Wang Y, Wang QJ. The prevalence of prehypertension and hypertension among US adults according to the new National Joint Committee Guidelines. Arch. Int. Med. 2004; 164(19):2126-34.

Greenlund KJ, Croft JB, Mensah GA . Prevalence of heart disease and stroke risk factors in persons with pre hypertension in the United States. Arch. Int. Med. 2004;164(19):2113-8.

Neter JE, Stam BE, Kok FJ, Grobbee DE, Geleijnse JM. Influence of weight reduction on blood pressure: a meta-analysis of randomized controlled trials. Hypertension. 2003;42:878-884 MA.

He FJ, MacGregor GA. How far should salt intake be reduced. Hypertension. 2003;42:1093-1099 RV.

Narkiewicz K, Phillips BG, Kato M et al. A gender selective interaction between aging, blood pressure and sympathetic nerve activity. Hypertension. 2005;45;522-52.

Cornelissen VA, Fagard RH. Effects of endurance training on blood hypertensive patients. Circulation. 2005;111:1012-1018.

Julius S, et al. Sympathetic overactivity in hypertension. Am J Hypertens. 1996;113-120.

About The Authors

Julia Georgieva Nikolova
Medical University - Plovdiv

Department of Physiology, Medical Faculty

Mariana Bacelova
Medical University - Plovdiv

Department of Physiology, Medical Faculty

Petar Hrischev
Medical University - Plovdiv

Department of Physiology, Medical Faculty

Margarita Hadjieva
Medical University - Plovdiv

Department of Physiology, Medical Faculty

Petar Nikolov
Medical University - Plovdiv

First Department of Internal Diseases - Section Cardiology, Medical Faculty

Daniela Koleva
Medical University - Plovdiv

Second Department of Internal Diseases - Section of Endocrinology, Medical Faculty

Font Size