Fluctuations And Spikes In Blood Pressure Of Young Adults Indicates High Risk Of Future Cardiovascular Problems In Middle Age
Source: Thailand Medical News Jan 24, 2020 4 years, 11 months, 1 day, 4 minutes ago
Frequent
fluctuations and wide swings in
blood pressure readings among
young adults are associated with a higher risk of
cardiovascular disease by
middle age, a new analysis led by Duke University medical researchers shows.
The research finding, published in
JAMA Cardiology, suggests that the current practice of averaging
blood pressure readings to determine whether medications are necessary could be masking a potential early warning sign from the
fluctuations themselves.
Lead author Dr Yuichiro Yano, M.D., Ph.D., Assistant Professor in Duke's Department of Family Medicine and Community Health told
Thailand Medical News, "If a patient comes in with one reading in December and a significantly lower reading in January, the average might be within the range that would appear normal. But is that difference associated with health outcomes in later life? That's the question we sought to answer in this study, and it turns out the answer is yes."
Dr Yano and colleagues arrived at their conclusion after analyzing 30 years of data from a large, diverse cohort of
young adults enrolled in the Coronary Artery Risk Development in
Young Adults study between March 1985 and June 1986.
From the collection of 3,394 people studied, about 46% were African American and 56% were women. The patients had regular
blood pressure checks, with patterns evaluated across five visits, including at two, five, seven and 10 years. At the 10-year mark, the average age of the patients was about 35.
The significant reading of concern to Dr Yano's research team was the systolic
blood pressure level, the upper number in the equation that measures the pressure in the blood vessels when the heart pumps. A systolic
blood pressure reading over 130 is considered hypertensive and has long been a major risk factor for
cardiovascular disease.
Dr Yano and colleagues were able to identify which
young adults had variations in systolic
blood pressure by the age of 35 and then track them over the next 20 years and see whether there appeared to be a correlating increase in c
ardiovascular disease.
From observations over those years, study participants reported 181 deaths and 162
cardiovascular events, which included fatal and nonfatal coronary heart disease, hospitalization for heart failure, stroke, transient ischemic attack, or a stent procedure for blocked arteries.
The medical researchers found that each 3.6-mm spike in systolic
blood pressure during
young adulthood was associated with a 15-percent higher risk for heart disease events, independe
nt of the averaged
blood pressure levels during
young adulthood and any single systolic
blood pressure measurement in midlife.
Dr Yano added, "Current guidelines defining hypertension and assessing the need for anti-hypertensive therapies ignore variability in
blood pressure readings. I think there has been a belief that variability is a chance phenomenon, but this research indicates maybe not. Variability matters."
Dr Yano said this study provides strong evidence that doctors and patients should be alert to
blood pressure variations in early adulthood, when there is time to instill lifestyle changes that could improve and even extend a person's life.
Reference : Yuichiro Yano et al. Association of Blood Pressure Patterns in Young Adulthood With Cardiovascular Disease and Mortality in Middle Age. JAMA Cardiol. Published online January 22, 2020. DOI: 10.1001/jamacardio.2019.5682
