Hypertension Puts Young at Risk

Isolated systolic hypertension (ISH) in young and middle-aged adults is on the rise. A study in the Journal of the American College of Cardiology found that ISH puts these patients at higher relative risk for heart disease and mortality than their peers with normal blood pressure. That raises the question of whether these younger ISH patients should be getting drug therapy.

Yuichiro Yano, MD, PhD and colleagues used data from 15,868 people in the Chicago Heart Association Detection Project in Industry study. The team found that in a 31 —year average followup period, there were 1,728 deaths from cardiovascular disease (CVD) , 1,168 from coronary heart disease (CHD), and 223 from stroke.

The found that in men with ISH the risk for CVD mortality was 1.23 times that of risk in controls, and for CHD mortality it was 1.23 times greater. Those studied were between 18 and 49 years old.

The prevalence of ISH has more than doubled from 0.7% in 1988 to 1.6% in 2004.

The authors conclude that while it has long been known that treating hypertension when it occurs in older patients is beneficial, there has been little research on whether younger people with that condition would benefit.

“Our data indicate that ISH in younger and middle-aged adults is not an innocuous condition,” they wrote.

However, they continued “We cannot definitively infer whether the excess CVD risk for ISH in younger and middle-aged adults warrants antihypertensive drug therapy or whether only lifestyle modification treatment is necessary.”

The research showed that the subjects with ISH tended to be less educated, more likely to be smokers, had a higher mean BMIs, higher mean heart rates, and higher mean total cholesterol levels than those with normal blood pressure.

“Further research is needed, including clinical trials and studies seeking better ways to identify younger and middle-aged adults with ISH who are at especially greater risk for developing CVD events,” they conclude.