Hypertension in young adults shows long-term heart risks

May 19, 2017, UT Southwestern Medical Center
Credit: CC0 Public Domain

Otherwise healthy young people with high systolic blood pressure over 140 are at greater risk for future artery stiffening linked to an increased risk of stroke as well as possible damage to the kidneys and brain, new research shows.

The condition, called isolated systolic hypertension (ISH), occurs in people 18 to 49 who exhibit of 140 or higher (versus the optimal of under 120), but a normal diastolic pressure of around 80. Systolic pressure is the top number in a and diastolic is the bottom number.

This study - the largest ever conducted in the U.S. looking at whether young, otherwise healthy ISH patients actually have a cardiovascular problem - suggests the common approach of ignoring higher systolic blood pressure levels in younger adults may be wrong, said study author Dr. Wanpen Vongpatanasin, Director of UT Southwestern Medical Center's Hypertension Program.

"I think we should consider treating these patients sooner rather than later," said Dr. Vongpatanasin, Professor of Internal Medicine in the Division of Cardiology at UT Southwestern Medical Center. "I'm concerned that not treating these individuals now will lead to more brain and kidney damage in the future. This condition is not going to get better. It's going to get worse."

Although the condition is commonly treated in elderly patients, some physicians have avoided treating it in younger patients, thinking the higher systolic reading was an anomaly related to youth that would self-correct, or perhaps even a sign of a stronger heart since it sometimes showed up in high school athletes, said Dr. Vongpatanasin, who holds the Norman and Audrey Kaplan Chair in Hypertension and the Fredric L. Coe Professorship in Nephrolithiasis in Mineral Metabolism at UT Southwestern.

The findings are important because although young people rarely have heart attacks or strokes, the incidence of isolated in Americans 18 to 39 more than doubled over the last two decades and is now estimated to be about 5 percent, Dr. Vongpatanasin said. Researchers suspect the growing numbers may be related to increasing rates of obesity.

This new study, published in the journal Hypertension, found that the threat of aortic stiffness is not only real, but also visible. UT Southwestern researchers examined 2,001 participants in the Dallas Heart Study, a population-based study of more than 6,000 adults in Dallas County. The researchers took (CMR) pictures of the participants' hearts to assess the condition of the aorta - the major artery that carries oxygenated blood from the heart to the body. A section of the aorta that leads directly from the , called the proximal aorta, was the part found to be stiffened in young individuals with high systolic blood .

The next step will be to scan kidneys, brains, and hearts of participants from the Dallas Heart Study to determine what effect the aortic stiffening has had.

The Dallas Heart Study is the centerpiece of the Donald W. Reynolds Foundation Cardiovascular Clinical Research Center in Dallas, one of three such Centers in the nation, along with those at Harvard and Johns Hopkins. The Dallas Heart Study is a multiethnic population-based study of 6,101 adults from Dallas County designed to:

  • Identify new genetic, protein, and imaging biomarkers that can detect cardiovascular disease at its earliest stages, when prevention is most effective.
  • Identify social, behavioral, and environmental factors contributing to cardiovascular risk in the community, leading to improved community-based interventions; and
  • Enhance our understanding of the biological basis of cardiovascular disease.

Explore further: Aorta more rigid in African-Americans, may explain rates of hypertension and heart disease

More information: Yuichiro Yano et al, Hemodynamic and Mechanical Properties of the Proximal Aorta in Young and Middle-Aged Adults With Isolated Systolic Hypertension, Hypertension (2017). DOI: 10.1161/HYPERTENSIONAHA.117.09279

Related Stories

Aorta more rigid in African-Americans, may explain rates of hypertension and heart disease

November 10, 2016
African-Americans have more rigidity of the aorta, the major artery supplying oxygen-rich blood to the body, than Caucasians and Hispanics, according to a study by UT Southwestern Medical Center cardiologists.

Blood pressure: know your numbers

April 18, 2017
(HealthDay)—Having high blood pressure makes you more likely to have heart disease or a stroke. But because high blood pressure doesn't usually cause warning symptoms, you could be at risk without even knowing it.

White coat and masked hypertension associated with higher rates of heart and vascular disease

November 9, 2015
Patients whose blood pressures spikes in the doctor's office but not at home, and patients whose blood pressure spikes at home but not in the doctor's office, suffer more heart attacks, heart failure, and strokes than patients ...

Study shows risk for younger adults with isolated systolic hypertension

January 26, 2015
Younger adults with elevated systolic blood pressure—the top number in the blood pressure reading—have a higher risk for cardiovascular disease and coronary heart disease than those with normal blood pressure, according ...

White coat hypertension may indicate risk for heart disease in some people

October 31, 2016
White coat hypertension, where patients have high blood pressure readings in a medical setting but normal blood pressure outside the doctor's office, is most likely an innocuous condition that is not a predictor of heart ...

Recommended for you

Eating yogurt may reduce cardiovascular disease risk

February 15, 2018
A new study in the American Journal of Hypertension, published by Oxford University Press, suggests that higher yogurt intake is associated with lower cardiovascular disease risk among hypertensive men and women.

Newly discovered gene may protect against heart disease

February 14, 2018
Scientists have identified a gene that may play a protective role in preventing heart disease. Their research revealed that the gene, called MeXis, acts within key cells inside clogged arteries to help remove excess cholesterol ...

Blood thinners may raise stroke risk in over-65s with kidney disease

February 14, 2018
People over 65 years old may be increasing their stroke risk by taking anticoagulants for an irregular heartbeat if they also have chronic kidney disease, finds a new study led by UCL, St George's, University of London and ...

Cardiac macrophages found to contribute to a currently untreatable type of heart failure

February 14, 2018
A team of Massachusetts General Hospital (MGH) investigators has discovered, for the first time, that the immune cells called macrophages contribute to a type of heart failure for which there currently is no effective treatment. ...

Study maps molecular mechanisms crucial for new approach to heart disease therapy

February 13, 2018
Creating new healthy heart muscle cells within a patient's own ailing heart. This is how scientists hope to reverse heart disease one day. Today, a new study led by UNC-Chapel Hill researchers reveals key molecular details ...

Quality toolkit improves care in Indian hospitals

February 13, 2018
A simple toolkit of checklists, education materials and quality and performance reporting improved the quality of care but not outcomes in hospitals in the south Indian state of Kerala and may have the potential to improve ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.