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High blood pressure before age 40 associated with previous stroke, heart disease

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By Reuters

People who develop high blood pressure before age 40 have a higher risk of heart disease and stroke in middle ages, suggests two new studies.

One of the studies followed 4,800 young adults in the United States and found elevated blood pressure before age 40 in conjunction with up to 3½ times greater risk of heart disease and stroke during approximately 1

9 years of follow-up.

The second study examined data of nearly 2.5 million young adults in South Korea for a decade and also found that high blood pressure before age 40 was associated with greater risk of heart disease and stroke. Women in this study had up to 76 percent higher risk of cardiovascular disease, while for men the risk was 85 percent higher compared to comrades with normal blood pressure.

“Elevated blood pressure in early adulthood can result in heart attacks of several mechanisms, and these blood pressure levels can develop to higher levels over time,” said Ramachandran Vasan from the Boston University School of Medicine and the School of Public Health.

Hypertension is often associated with other risk factors, e.g. obesity, high cholesterol, high blood sugar and smoking, which increases the risk of stroke and myocardial infarction, Vasan, author of an accompanying editorial, said via email. These can damage target organs, including the hearts and arteries, and promote thickening of the arterial walls and the development of cholesterol and plaque in arteries, “thus creating a substrate (” soil “, if desired) for future myocardial infarction and stroke.”

For the studies , published on Tuesday in the Journal of the American Medical Association, the researchers assessed high blood pressure with new aggressive target levels recommended by the American Heart Association and the American College of Cardiology 2017. The new recommendations were based on new evidence suggesting that even elevated blood pressure early in Life can be a precursor to cardiovascular disease when people age.

Patients were classified as having high blood pressure when their highest reading or systolic pressure (reflects the pressure against arterial walls when the heart beats), an average of at least 130 millimeters of mercury.

They were also considered to have bottom-bottom or diastolic hypertension (reflective pressure against arterial walls when the heart rests between strokes) on average 80 mm mercury.

Before the new 2017 recommendations, people did not detect high blood pressure until they had measured 140/90 or higher.

Not all doctors have treated patients with the new, more aggressive blood pressure target, partly concerned that prolonged use of medicines to lower blood pressure may have side effects such as diarrhea or constipation, dizziness, fatigue, headache, nausea or vomiting or mood disorders.

Even though young adults with high blood pressure should consider the potential for side effects of the medicine, they can manage their blood pressure with lifestyle changing like eating better or exercising more, and they should discuss these alternatives with their doctor, said the senior author to the Korean the study, Dr Sang-min Park in Seoul Nati University Hospital.

“We have shown that high blood pressure, even at young age, may be associated with a higher risk of myocardial infarction or stroke,” said Park by e-mail. “Therefore, young adults with high blood pressure should monitor their blood pressure regularly and manage their blood pressure levels through lifestyle changes or medications.”

Lifestyle changes are beneficial not only to reduce blood pressure and the risk of cardiovascular disease, but could also lead to improved physical and mental health, Park noted.

No study investigated whether aggressive blood pressure management can prevent people from developing heart disease or die of it.

However, the results still indicate that blood pressure is treated more aggressively at a younger age can help minimize the risk of premature cardiac problems later in life, says the US-based study author, Dr. Yuichiro Yano of Duke University.

“Our study is among the first to report that people younger than age 40 who have elevated blood pressure or high blood pressure have an increased risk of heart failure, stroke and blood vessel blockages when they age,” says Yano via email.

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