ISOLATED SYSTOLIC HYPERTENSION IN YOUNG, MIDDLE-AGED AND OLDER PEOPLE – FINDINGS FROM THE INTERNATIONAL ACADEMIC 24HOUR ACADEMIC BLOOD PRESSURE CONSORTIUM (I24ABC)
Bibliographic record
Abstract
Objective: Comprehensive hemodynamic data, obtained with 24hour ambulatory blood pressure monitoring (24hABPM), comparing isolated systolic hypertension (ISH) with normotension (NTN) and the other hypertension phenotypes (systolic-diastolic hypertension - SDH, isolated diastolic hypertension - IDH) are sparse.Design and method: We compared steady-state (cardiac output – CO, total peripheral resistance – TPR) and pulsatile (brachial and central Pulse Pressure - bPP, cPP, Augmentation Index – AIx, Augmentation Pressure – AP, amplitude of forward – Pf and backward – Pb wave, estimated aortic pulse wave velocity - ePWV) hemodynamics, obtained with identical validated oscillometric cuff-based devices in a large academic research consortium, between ISH, NTN, IDH, and SDH across a wide age range. Hemodynamics were derived from brachial waveforms, calibrated with mean/diastolic BP, and processed with validated ARCSolver algorithms. Participants were divided into a younger (9-35 years), middle (36-65 years) and older (66-104 years) age group. Results: Overall, 8837 participants (47.9% women, 9-104 years old, 37.9% with treated hypertension) were included. Based on 24hABPM, 46.0%, 16.2%, 10.2% and 27.6% had NTN, IDH, ISH and SDH, respectively. ISH was rare in the youngest group (9-35years) – 6.8%, very rare in middle age – 4.7%, and more common in the oldest age group (66-104 years) – 17.4%. There were striking sex-related differences: the percentage of women with ISH was 10.9%, 68.4% and 65.6% in the youngest, middle and oldest group, respectively. Independent of age, ISH participants were characterized by the highest values for bPP, cPP, antegrade and reflected waves (AP, Pf, Pb), and ePWV, and the lowest heart rate (Table). In addition, young ISH participants had the highest CO among all BP phenotypes. Of note, middle-aged and elderly ISH participants had the highest LVMi among all BP phenotypes. Conclusions: ISH phenotype, based on brachial 24hABPM, is not unfrequently observed in a large multinational convenience sample, with striking sex-differences among young and middle-aged/elderly participants. ISH has unique hemodynamic features across all age groups, namely unfavourable pulsatile hemodynamics. In addition, LVMi as a common metric of cardiac organ damage is highest among all BP phenotyps in middle-aged and elderly ISH participants.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".