Prehigh blood pressure during young adulthood is common and is linked to subsequent coronary atherosclerosis, as per a research studypublished in today's issue of Annals of Internal Medicine
Scientists from the University of California, San Francisco, analyzed blood pressure measurements of 3,560 adults aged 18 to 30 from seven examinations over the course of 20 years. Nearly 20 percent (635) of the study participants developed prehigh blood pressure (systolic blood pressure 120 to 139 mmHg or diastolic blood pressure 80 to 89 mmHg) before the age of 35.

Eventhough these blood pressure levels are below the cutoff for hypertension, the young adults with prehigh blood pressure were more likely than those with lower blood pressure to have calcium in their coronary arteries during the later part of life. Coronary calcium is a marker of atherosclerosis and a predictor of future heart attacks and strokes.

"Our findings suggest the possibility that prehigh blood pressure itself is harmful, and not just because it is linked to subsequent hypertension," said Mark J. Pletcher, MD, MPH, the study's lead author. "People with a lot of calcium in their coronary arteries are more likely to have heart attacks and strokes, and these outcomes might be avoidable by keeping blood pressure low when you're young".

Dr. Pletcher notes, however, that the study only shows an association between prehigh blood pressure in young adults and coronary calcium during the later part of life, and that blood pressure medications have not been proven to prevent cardiovascular disease in young adults with prehypertension.

Prehigh blood pressure was most common in young adults who were black, male, overweight, and of low socioeconomic status. Participants with low annual income (less than $25,000) and no college education were about twice as likely to have had early prehigh blood pressure as were participants with postgraduate education and an annual income greater than $100,000. Prehigh blood pressure before the age of 35 also was linked to having diabetes, low HDL cholesterol levels, and higher exposure to blood pressure elevation during the later part of life.

Systolic prehigh blood pressure appeared to be more important than diastolic prehypertension, and the association was graded: the higher and the longer exposure to prehigh blood pressure during young adulthood, the higher the likelihood of having coronary calcium during the later part of life.

The authors think that their findings support existing recommendations to optimize blood pressure early in adulthood with lifestyle modifications such as regular physical activity, healthy eating, and weight control with the goal of lowering blood pressure to less than 120/80 mmHg and preventing progression to hypertension.

Eventhough coronary calcium is a strong predictor of future coronary heart disease, the editors of Annals of Internal Medicine caution that not all patients with coronary artery calcium go on to develop cardiovascular disease.


Posted by: April    Source

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