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People who develop high blood pressure before the age of 40 have a higher risk of heart disease and middle-age strokes, suggesting two new studies.
One study followed 4,800 young adults in the United States and found high blood pressure before the age of 40 associated with a risk of up to 3½-fold higher heart disease and stroke during 19 years of follow-up.
The second study examined data on nearly 2.5 million new adults in South Korea over a decade and also found that high blood pressure before the age of 40 was associated with a higher risk of heart disease and stroke. Women in this study had up to 76 percent more risk of cardiovascular disease, while for men, the risk was 85 percent higher compared to peers with normal blood pressure.
"High blood pressure in adulthood can cause heart attacks by various mechanisms and these levels of blood pressure can progress to higher levels over time," said Ramachandran Vasan of the School of Medicine of the University of Boston and the School of Health Public
High blood pressure is usually associated with other risk factors, such as excess weight, high cholesterol, blood sugar and smoking, which increase the risk of stroke and heart attacks. Vasan, author of an accompanying publisher, said by email. These can damage the target organs, including the heart and arteries, and promote the thickening of the arterial walls and the accumulation of deposits and cholesterol plaques in the arteries, "thus creating a substrate (" ground ", if desired) for future heart attacks and stroke. "
For the studies, both published on Tuesday in the American Medical Association, researchers evaluated high blood pressure using new aggressive target levels recommended by the American Heart Association and the American College of Cardiology in 2017. The new recommendations were based on emerging evidence that They suggest that lightweight blood pressure at the beginning of life can be a precursor of cardiovascular disease as people grow older.
Patients were classified as hypertensive when most of their reading or systolic pressure (which reflected the pressure against the walls of the arteries when the heart is late) had an average of at least 130 milliliters of mercury.
It was also considered that they had hypertension if the lower number or the diastolic pressure (which reflected the pressure against the walls of the arteries when the heart rested between beats) had an average of at least 80 milliliters of mercury.
Prior to the new recommendations in 2017, people were not diagnosed with high blood pressure until they had measurements of 140/90 or higher.
Not all doctors treated patients using the new, more aggressive blood pressure objective, partly because of the long-term use of medications to lower blood pressure could have side effects, such as diarrhea or constipation, dizziness, fatigue, headaches, nausea or vomiting or mood disorders.
While young adults with high blood pressure should consider possible side effects for medication, they may be able to control their blood pressure with lifestyle changes, such as eating better or exercising more, and discuss these options with your doctor, said the lead author of the Korean study, Dr. Sang-min Park of the Seoul National University Hospital.
"We show that hypertension even at an early age can be associated with a higher risk of heart attacks or strokes," said Park by email. "Therefore, young adults with hypertension should control their blood pressure regularly and manage their blood pressure levels for lifestyle changes or medications."
Lifestyle changes are beneficial not only to reduce blood pressure and the risk of cardiovascular disease, but also to improve physical and mental health, Park observed.
None of the studies studied whether aggressive blood pressure treatment can prevent people from developing heart disease or dying for it.
But the results still suggest that treating blood pressure more aggressively at a younger age can help minimize the risk of premature cardiac problems later in life, said the lead author of Dr. Yuichiro Yano from the University of Duke.
"Our study is among the first to report that people younger than 40 years of age who have high blood pressure or hypertension are at greater risk of heart failure, strokes and blockage of blood vessels when they are aging," said Yano by email.