High systolic blood pressure – the top number in a blood pressure reading – has long been considered an indicator of cardiovascular disease risk for adults over 50. But now a new Northwestern Medicine study suggests that it’s also important for younger adults.
The study, published in the Journal of the American College of Cardiology, included long-term data collected from 27,000 people between the ages of 18 and 49. The investigators tracked outcomes for men and women with isolated systolic hypertension, which is high systolic blood pressure (140 mm Hg or greater) and normal- or near-normal diastolic blood pressure (less than 90 mm Hg).
Men who had isolated systolic hypertension at the beginning of data tracking had a 23 percent increased risk of cardiovascular death at follow-up 30 years later, compared to men who had normal blood pressure. Women with isolated systolic hypertension had a 55 percent increased risk of cardiovascular death.
“The dangers of isolated systolic hypertension are very well known for older populations,” said lead author Yuichiro Yano, MD, a postdoctoral fellow in Preventive Medicine. “But guidelines do not recommend any treatment for younger populations with isolated systolic hypertension, because there has been no evidence until now showing that it increases their risk for cardiovascular disease.”
The results of the study may encourage physicians to consider treatment plans for younger patients with high systolic blood pressure, such as lifestyle modifications or drug therapy, though more research is needed before new intervention recommendations can be made, Yano said.
“We need evidence that shows lowering blood pressure in younger people protects against future disease,” he said.
The connection between growing obesity rates and early onset high blood pressure is another factor for future investigation.
“Data for our study began in the late 1960s. If we do this kind of research now, we might detect even more risk for isolated systolic hypertension in younger populations,” said Yano.
The investigators used data initially collected between 1967 and 1973 from the Chicago Heart Association Detection Project in Industry study. Yano and colleagues excluded participants who had pre-existing coronary heart disease and those on antihypertensive medications at baseline.
Additional Feinberg authors include Jeremiah Stamler, MD, professor emeritus in Preventive Medicine-Epidemiology, Daniel Garside, Martha Daviglus, MD, PhD, adjunct professor in Preventive Medicine and Medicine-General Internal Medicine and Geriatrics, Mercedes Carnethon, PhD, associate professor in Preventive Medicine-Epidemiology, Kiang Liu, PhD, professor in Preventive Medicine-Epidemiology and Medicine-General Internal Medicine and Geriatrics, Philip Greenland, MD, Harry W. Dingman Professor of Cardiology, and Donald Lloyd-Jones, MD, ScM, Eileen M. Foell Professor.
This study was supported by the American Heart Association and its Chicago and Illinois affiliates; National Heart, Lung, and Blood Institute grants R01-HL 15174, R01-HL 21010 and R01-HL 03387; the Northwestern Memorial Foundation; and the Goldberg Family Charitable Trust.