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People who develop high blood pressure before age 40 have a higher risk of heart disease and stroke in middle ages, suggests two new studies.
One of the studies followed 4,800 young adults in the United States and found a high blood pressure before age 40 which was associated with up to 3½ times greater risk of heart disease and stroke during approximately 19 years of follow-up.
The second study examined data of nearly 2.5 million young adults in South Korea for a decade and also found that high blood pressure before age 40 was associated with greater risk of heart disease and stroke. Women in this study had up to 76 percent higher risk of cardiovascular disease, while for men the risk was 85 percent higher compared to comrades with normal blood pressure.
"Elevated blood pressure in early adulthood can result in multiple myocardial infarction, and these blood pressure levels can develop to higher levels over time," said Ramachandran Vasan of the Boston University School of Medicine and Public Health School.
Hypertension is often associated with other risk factors, such as obesity, high cholesterol, high blood sugar and smoking, which increases the risk of stroke and myocardial infarction, Vasan, author of an accompanying editorial, said via email. These can damage target organs, including the hearts and arteries, and promote thickening of the arterial walls and the development of cholesterol and plaque in arteries, "thus creating a substrate (" soil ", if desired) for future myocardial infarction and stroke."
For the studies, both published Tuesday in the Journal of the American Medical Association, researchers assessed high blood pressure with new, more aggressive target levels recommended by the American Heart Association and the American College of Cardiology 2017. The new recommendations were based on emerging evidence suggesting that something Elevated blood pressure early in life can be a precursor of cardiovascular disease when people age.
Patients were classified as having high blood pressure when their highest reading or systolic pressure (reflecting the pressure on the arteries when the heart beat) was on average at least 130 millimeters of mercury.
They were also considered to have high blood pressure on the lower number or diastolic pressure (reflective pressure against arterial walls when the heart rests between strokes) on average at least 80 millimeters of mercury.
Before the new recommendations in 2017, people with high blood pressure did not diagnose until they had measured 140/90 or higher.
Not all doctors have treated patients with the new, more aggressive blood pressure target, partly concerned that prolonged use of drugs to lower blood pressure may have side effects such as diarrhea or constipation, dizziness, fatigue, headache, nausea or vomiting or mood disorders.
While young adults with high blood pressure should consider the potential for side effects of the drug, they may be able to cope with their blood pressure with lifestyle changes such as eating better or exercising more, and they should discuss these options with their doctor, says the senior author of the Korean study, Dr Sang -min Park in Seoul National University Hospital.
"We have shown that high blood pressure, even at a young age, may be associated with a higher risk of myocardial infarction or stroke," said Park by e-mail. "Therefore, young adults with high blood pressure should monitor their blood pressure regularly and manage their blood pressure levels through lifestyle changes or medications."
Lifestyle changes are beneficial not only to reduce blood pressure and the risk of cardiovascular disease, but can also lead to improved physical and mental health, Park is noted.
No study investigated whether aggressive blood pressure treatment can prevent people from developing heart disease or die of it.
But the results still indicate that treatment of blood pressure more aggressively at a younger age can help minimize the risk of premature heart problems later in life, says the US-based study's main author, Dr. Yuichiro Yano of Duke University.
"Our study is among the first to report that people under 40 years of age who have elevated blood pressure or high blood pressure have an increased risk of heart failure, stroke and blood vessel blockage when filling," says Yano via email.
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