Hypertension in Young Adulthood Linked to CVD Later in Life

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Two studies show increased risk for cardiovascular disease in association with hypertension.
Two studies show increased risk for cardiovascular disease in association with hypertension.

(HealthDay News) -- High blood pressure (BP) in early adulthood is associated with an increased risk for cardiovascular disease (CVD) later in life, according to 2 studies published in the Nov. 6 issue of the Journal of the American Medical Association.

Yuichiro Yano, MD, PhD, from Duke University in Durham, North Carolina, and colleagues examined the risk for CVD events associated with hypertension in young adults aged 18 to 30 years from 4 US field centers. Data were included for 4851 adults. The researchers identified 228 incident CVD events during a median follow-up of 18.8 years. The CVD incidence rates were 1.37, 2.74, 3.15, and 8.04 for normal BP, elevated BP, stage 1 hypertension, and stage 2 hypertension, respectively. After multivariable adjustment, the hazard ratios (HRs) for CVD events were 1.67, 1.75, and 3.49 for elevated BP, stage 1 hypertension, and stage 2 hypertension, respectively, compared with normal BP.

Joung Sik Son, MD, from the Seoul National University Hospital in South Korea, and colleagues categorized 2,488,101 Korean adults aged 20 through 39 years according to BP readings and examined the correlation between categories and risk for CVD later in life. During a median follow-up of 10 years, the researchers observed 44,813 CVD events. Compared with those with normal BP, increased risks for CVD, coronary heart disease (CHD), and stroke were seen for men with baseline stage 1 hypertension (adjusted HRs, 1.25, 1.23, and 1.30, respectively) and women with stage 1 hypertension (adjusted HRs, 1.27, 1.16, and 1.37, respectively). Results were consistent for stage 2 hypertension.

"Overall, these data emphasize that primary prevention of higher blood pressure levels must begin in childhood," writes the author of an accompanying editorial.

One author from the Yano study disclosed financial ties to the pharmaceutical industry.

References

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. DOI:10.1001/jama.2018.13551

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):1783-1792. DOI:10.1001/jama.2018.16501

Vasan RS. High Blood Pressure in Young Adulthood and Risk of Premature Cardiovascular Disease: Calibrating Treatment Benefits to Potential Harm. JAMA. 2018;320(17):1760-1763. DOI:10.1001/jama.2018.16068

Fisher NDL, Curfman G. Hypertension—A Public Health Challenge of Global Proportions. JAMA. 2018;320(17):1757-1759. DOI:10.1001/jama.2018.16760

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