Arterial stiffness is increased in young normotensive subjects with high central blood pressure

• We describe for the first time a new blood pressure (BP) pattern in young subjects.
• This pattern is characterized by normal peripheral and high central BP values.
• This BP pattern is associated with a worse CV risk profile and higher risk of TOD.
• Some easy clinical predictors can help clinicians to identify this BP pattern.
• Other studies may be useful to demonstrate the prognostic impact in adult age.

Information on high central blood pressure (CBP; HCP) in normotensive subjects (NT) and its relation to target organ damage (TOD) is not well established in young subjects. This study aimed to elucidate determinants of HCP and its relation with TOD. Anthropometrics, lab, brachial, and CBP were obtained on 430 normotensive subjects (NT; 16–24 years, 34% male, 44% Caucasian, 27% type 2 diabetes). HCP was defined as elevated CBP, with normal brachial BP. Subjects with HCP (prevalence, 16%) were more frequently female and African American, and had a higher prevalence of obesity and diabetes, a more adverse metabolic profile, higher levels of inflammation, brachial BP, central pulse pressure, and heart rate compared with NT. HCP also had evidence for TOD with a significant higher carotid intima media thickness, left ventricular mass, augmentation index, pulse wave velocity, and lower brachial distensibility than NT. HCP is related to early cardiac and vascular dysfunction and remain an independent predictor of TOD even after adjusting for cardiovascular risk factors.