In Young Adults, BP Could Signal Later Heart Health

High-normal blood pressure readings in young adults may signal heart problems in middle age

(RxWiki News) Keeping it low is a good thing when it comes to blood pressure. That may be especially true for young adults.

A new study looked at blood pressure in young adults and found that those who had blood pressure in the high end of the normal range had a heightened risk of heart failure in middle age.

"Our findings provide further support for the importance of good risk factor control early in life," said lead study author João A.C. Lima, MD, of Johns Hopkins University School of Medicine, in a press release. "Many participants were not hypertensive at the beginning of the study; however, chronic exposure to higher blood pressure, even within what is considered the normal range, is associated with cardiac dysfunction 25 years later."

Marc Goldschmidt, MD, director of the Heart Success Program at Morristown Medical Center in New Jersey, told dailyRx News, "This is an important trial evaluating the cumulative effects of hypertension over a 25-year span in an otherwise young, healthy population. Using myocardial strain imaging, the study investigators suggest that [echocardiograms] may be helpful in identifying high-risk individuals before end-organ damage and overt congestive heart failure occurs."

Dr. Lima led a research team during a long-term study called Coronary Artery Risk Development in Young Adults, or CARDIA. The study began in 1985.

Patients were 18 to 30 years old in 1985. Dr. Lima and colleagues collected data from health assessments of 2,479 men and women. These data included regular blood pressure readings.

In 2010 and 2011, these researchers re-evaluated study patients with a test called an echocardiogram. The echocardiogram allows doctors to see how well the heart chambers and valves work when the heart beats.

During this study, patients came in for regular assessments of their health, including blood pressure readings.

High blood pressure can increase the risk of heart attack, heart failure and stroke. A blood pressure of 120 over 80 millimeters of mercury is considered normal.

Study patients who had “high normal” blood pressure readings over a long period of time were more likely to show evidence of heart failure in middle age.

Dr. Lima and colleagues said young adults should follow medical recommendations to reduce raised blood pressure. Recommendations could include taking medication, quitting smoking and adjusting diet.

"The observation that cumulative exposure to [high] blood pressure from young adulthood is associated with [heart] function in middle age raises critical questions about the importance of blood pressure even earlier in life and the need for longitudinal studies commencing in childhood,” wrote Thomas H. Marwick, MD, PhD, of the Menzies Institute for Medical Research in Australia, in an editorial about this study.

Dr. Goldschmidt added, "This trial again re-emphasizes the importance of early diagnosis and treatment in preventing or mitigating the long-term consequence of hypertension."

The study and editorial were published in the June issue of the Journal of the American College of Cardiology.

The CARDIA Study was funded by grants from the National Heart, Lung, and Blood Institute and the Intramural Research Program. Dr. Lima and team disclosed no conflicts of interest.

Review Date: 
June 23, 2015