Blood Pressure as a Predictor of Atherosclerosis

Coronary artery calcium at later age associated with high blood pressure patterns during young adult years

(RxWiki News) High blood pressure is a risk factor for heart and vessel disease, but can blood pressure patterns in young adults affect heart health later in life?

A research team studied patterns of blood pressure changes in young adults and linked them with heart and blood vessel disease 25 years later.

The study found five blood pressure patterns in young adults. The patients who showed patterns of elevated and increasing blood pressure levels throughout the study had increased chances of having higher measures of coronary artery calcification, a measure of coronary artery atherosclerosis.

"Ask your doctor about ways to control your blood pressure."

This team of researchers was led by Norrina B. Allen, PhD, MPH, from Northwestern University in Chicago, Illinois.

The researchers collected data on 4,681 people. The study participants were men and women, Caucasian and African-American, who were ages 18 to 30 at the beginning of the study in 1985 through 1986.

To detect patterns of blood pressure readings, the study team looked at blood pressure at 2, 5, 7, 10, 15, 20 and 25 years into the study. They correlated the blood pressures with findings of coronary heart calcium at 25 years.

Scans of the arteries that supply blood to the heart muscle, called coronary arteries, were done to detect deposits of calcium. Calcium deposits in blood vessels of the heart are sometimes used to indicate heart attack risk, according to the Mayo Clinic. The researchers conducting this study scored the calcium deposits, with a higher score indicating a greater amount of calcium.

Analysis of the data showed five different blood pressure patterns over the 25 years the blood pressure readings were taken. The patterns corresponded to blood pressures that were low and stable, slightly elevated and stable, high and stable, slightly increasing, and high and increasing over the 25-year period.

The greatest percentage of people in the high and increasing blood pressure group was African Americans at 79.3 percent of that group. The greatest percentage of people in the low and stable blood pressure group was in Caucasians, who made up 70.6 percent of that group.

At the beginning of the study and at year 25, the group with the highest percentage of smokers was the high and increasing blood pressure group. At the beginning of the study, 37.5 percent of the high and increasing blood pressure group was smokers. Notably, the percentage of smokers in each blood pattern group decreased from the beginning of the study to those smoking at year 25.

Many participants were taking medication for their blood pressure at 25 years into the study. More of the participants in the group who had high and increasing blood pressure were taking antihypertensives than those in the other groups.

Some patterns of blood pressure increased the risk of higher coronary calcium scores at 25 years. Participants in the slightly elevated and stable blood pressure group had a 2.7 percent increase for higher calcium scores, and the slightly elevated and increasing group had a 5 percent higher risk compared to the group with low and stable blood pressure.

The group with high blood pressure had the greatest risk of higher coronary calcium scores in 25 years. The high and stable blood pressure group had a 6.3 percent increased risk, and the high and increasing blood pressure group had a 12.9 percent greater risk compared to the group with low and stable blood pressure.

The researchers noted several limitations of their study. Two limitations were that not all participants had blood pressure readings taken at every time point throughout the 25 years of the study, and blood pressures were not known in the years before the participants entered the study when they were between the ages of 18 and 30.

Dr. Allen and her team concluded, "Although BP has been a well-known risk factor for CVD for decades, these findings suggest that an individual's long-term patterns of change in BP starting in early adulthood may provide additional information about his or her risk of development of coronary calcium."

"Additional research is needed to examine the utility of specific BP trajectories in risk prediction for clinical CVD events and to explore the effect of lifestyle modification, treatment, and timing of intervention on lifetime trajectories in BP and outcomes."

The research study was published in the February issue of JAMA.

Funding for the data used in this study was provided by the National Heart, Lung and Blood Institute, in collaboration with the University of Alabama, Northwestern University, University of Minnesota, Kaiser Foundation Research Institute and Johns Hopkins University school of Medicine. Partial support was provided by the Intramural Research program of the National Instate on Aging.

One of the authors disclosed that she received grants from Merck, was paid by Merck for lectures and was a member of a data and safety monitoring board for Takeda.

Review Date: 
February 3, 2014