Hypertension

Hypertension Before Age 40 Could Lead to High CVD Risk

Having elevated blood pressure (BP)—defined by the 2017 ACC/AHA hypertension guidelines—before the age of 40 years is associated with a significantly increased risk of cardiovascular events in middle age, according to the results of 2 recent studies.

 

In the first study, a prospective cohort study of 4851 young adults aged 18 to 30 years, CVD incidence rates in individuals with normal BP (untreated systolic BP [SBP] <120 mm Hg and diastolic BP [DBP] <80 mm Hg, elevated BP (untreated SBP 120-129 mm Hg and DBP <80 mm Hg), stage 1 hypertension (untreated SBP 130-139 mm Hg or DBP 80-89 mm Hg), or stage 2 hypertension (SBP ≥140 mm Hg, DBP ≥90 mm Hg, or taking antihypertensive medication) were 1.37, 2.74, 3.15, and 8.04 per 1000 person-years, respectively. 1

 

In the second study, a nationwide cohort of 2,488,101 Koreans aged 20 through 39 years, men with baseline stage 1 hypertension (systolic, 130-139 mm Hg; diastolic, 80-89 mm Hg) compared with those with normal blood pressure (systolic, <120 mm Hg; diastolic, <80 mm Hg) had higher risk of CVD (adjusted hazard ratio [HR] 1.25), CHD (adjusted HR 1.23), and stroke (adjusted HR 1.30). Women with baseline stage 1 hypertension had increased risk of CVD (adjusted HR 1.27), CHD (adjusted HR 1.16), and stroke (adjusted HR 1.37). 2

 

“The ACC/AHA blood pressure classification system may help identify young adults at higher risk for cardiovascular disease events,” the researchers concluded.1

 

—Michael Potts

 

References:

  1. Yano Y, Reis JP, Colangelo LA, et al. Association of blood pressure classification in young adults using the 2017 American College of Cardiology/American Heart Association blood pressure guideline with cardiovascular events later in life. JAMA. 2018;320(17):1774-1782.
  2. Son JS, Choi S, Kim K, et al. Association of blood pressure classification in korean young adults according to the 2017 American College of Cardiology/American Heart Association guidelines with subsequent cardiovascular disease events. JAMA. 2018;320(17):1783-179