Study: Risks Seen in People Under 40 with Hypertension

People under the age of 40 with hypertension are at an increased risk for heart failure (HF), stroke, and other adverse events, a new study in the Journal of the American Medical Association suggested.  

In this cohort study, adults ages 18 to 30 with 2017 @ACCinTouch/@American_Heart guideline-defined stage 1 and 2 #hypertension before age 40 had increased long-term risk for #CVD events including myocardial infarction, #heartfailure, and stroke. https://t.co/xLlFqfKxhD #AHA18 pic.twitter.com/iuZJQ91AUP

— JAMA (@JAMA_current) November 7, 2018

Researchers for the observational study of 4,851 young adults (aged 18-30 years) with elevated blood pressure (BP), stage 1 hypertension, and stage 2 hypertension. Normal BP  was classified as untreated systolic BP (SBP) < 120 mm Hg and diastolic BP (DBP) < 80 mm Hg (n = 2574); elevated BP as untreated SBP 120-129 mm Hg and DBP < 80 mm Hg (n = 445); stage 1 hypertension as untreated SBP 130-139 mm Hg or DBP 80-89 mm Hg (n = 1194); or stage 2 hypertension (SBP ≥ 140 mm Hg, DBP ≥ 90 mm Hg), or taking antihypertensives (n = 638). Primary study outcomes were cardiovascular disease events including fatal and nonfatal coronary heart disease, heart failure, stroke, transient ischemic attack, or intervention for peripheral artery disease. Median follow-up was 18.8 years. 

According to the results, CVD incidence rates for elevated BP (HR=1.67; 95% CI, 1.01 to 2.77), stage 1 hypertension (HR=1.75; 95% CI, 1.22 to 2.53), and stage 2 hypertension (HR=3.49; 95% CI, 2.42 to 5.05) were successively higher with each successive level of BP increase. A total of 228 CVD events were reported during follow-up. 

“”Among young adults, those with elevated blood pressure, stage 1 hypertension, and stage 2 hypertension before age 40, as defined by the 2017 guidelines, had significantly higher risk for subsequent cardiovascular disease events, compared to those with normal blood pressure before age 40,” lead author Yuichiro Yano, MD, PhD, assistant professor in the Department of Community & Family Medicine at Duke, said in a press release of the study results. 

Important article on hypertension in young adults. It is never too early to reduce sodium and eat a healthy diet.https://t.co/Kjz0rKLuZf

— Stephen Juraschek MD, PhD, FAHA, AHSCP-CHS (@spjuraschek) November 7, 2018

Young adults➡️those w/ elevated BP, stage1&stage2 HT < 40 yrs, as defined by the BP classification in the 2017 ACC/AHA guidelines, had significantly ⬆️ risk for subsequent CVD events compared w/ those w/ normal BP < age 40 yrs. https://t.co/bJVkctzEgl@SEMERGENap @SEHLELHA140_90 pic.twitter.com/0jgAQkHkhU

— Vicente Pallares (@vic_pallares) November 7, 2018

Sources: JAMA