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High Blood Pressure in Young Adults Tied to Earlier Strokes

TUESDAY, Nov. 6, 2018 (HealthDay News) – Two new studies suggest that when people under 40 develop high blood pressure, their risk of early heart disease and stroke goes up significantly.

The first study found in a group of about 5,000 young American adults, having high blood pressure is a higher risk of heart disease and stroke.

And the second study found nearly 2.5 million young adults from Korea, and also found that blood pressure increased their risk of premature heart disease and stroke by 85 percent.

Both studies relied on the new blood pressure guidelines from the American College of Cardiology and the American Heart Association. These guidelines set a lower threshold for what is considered high blood pressure. Stage 1 high pressure blood pressure is above 130/80 mm Hg, and is considered stage 2 high blood pressure if it rises above 140/90 mm Hg.

There's been some debate about whether these new guidelines are too strict, and they haven't been universally adopted. For example, they aren't yet being used in Europe.

However, the lead author of the first study, Dr. Yuichiro Yano from Duke University, said their findings show that "the new blood pressure guidelines help identify young adults at higher risk of cardiovascular events and all-cause mortality. The new blood pressure guidelines seem reasonable."

According to the new guidelines, a normal blood pressure system is less than 80 (diastolic).

Editorial co-author Dr. Gregory Curfman, who is a deputy editor of the Journal of the American Medical Association, said the findings from the two very different populations that are "really strong evidence" that the new guidelines are identifying the high blood pressure in adults under 40.

What's surprising under the new guidelines is just how many people have high blood pressure when the lower threshold is used. In the United States, the new guidelines mean that 46 percent of Americans have high blood pressure, up from 32 percent. In China, the number is now 50 percent, up from 25 percent. And in India, it's now 43 percent where it used to be 29 percent, according to the editorial.

One reason these rates may be so high that high blood pressure often doesn't have symptoms.

Curfman's co-author, Dr. Naomi Fisher from Harvard Medical School, said, "For many patients, high blood pressure is abstract disease, hypertension is almost impossible to visualize or localize. Add that it rarely causes symptoms, and that is damage – – like a heart attack or stroke – often takes years to occur, and it's easy to understand why the public is underestimating high blood pressure. "

But Fisher said people can do a lot of blood pressure control.

"We need to help and understand them the power they have to control their health," she said.

One step is regularly monitoring blood pressure at home. People with high blood pressure also need to "prioritize healthy lifestyle changes. Even with medication, healthy living imperative control hypertension. This means a healthy diet and a healthy weight, restricted sodium. [salt] and alcohol intake, and regular exercise, "Fisher said.

"This work is hard," she added, "but it pays off."

Yano noted that if young people with high blood pressure can bring it down, the risk of heart disease and stroke might also come down.

The people in Yano's study were an average age of 36 when the study began. The study group was almost even divided between white and black people. About 230 people had a heart attack, stroke or heart failure during the nearly 19-year follow-up period.

People with elevated blood pressure (120-129 / less than 80 mm Hg) has 67 percent higher risk of heart disease or stroke. Those with stage 1 high blood pressure (130/80 and higher) had a higher risk of 75 percent, and those with stage 2 high blood pressure (140/90 and higher) had a 3.5 times higher risk of heart disease or stroke compared to someone with normal blood pressure, the study found.

In the Korean study, the average age was 31 years old. Nearly 45,000 cardiovascular events (heart disease or stroke) were reported during the study's average 10-year follow-up. Young adults with stage 1 high blood pressure have a higher risk of heart disease or stroke compared to those with normal readings. For those with stage 2 high blood pressure, the risk of heart disease or stroke was 76 percent higher in 85 percent higher in women.

Findings from both studies were published in the Nov. 6 issue of the Journal of the American Medical Association.

More information

Learn more about managing high blood pressure from the American Heart Association.

SOURCES: Yuichiro Yano, M.D., Ph.D., assistant professor, department of community and family medicine, Duke University, Durham, N.C .; Gregory Curfman, M.D., deputy editor, Journal of the American Medical Association; Naomi Fisher, M.D., director, Hypertension Service and Hypertension Innovation, and associate professor, medicine, Harvard Medical School, Boston; Nov. 6, 2018, Journal of the American Medical Association

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