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Elevated blood pressure in people under 40 poses hazard of developing CVD prematurely

November 06, 2018

(Boston)--High blood pressure or hypertension is a major health problem that affects more than 100 million people in the U.S. (using the current 130 systolic or 80 diastolic) and over one billion worldwide. Despite being considered a disease of older adults two new studies in the Journal of the American Medical Association (JAMA) are reporting the association of high blood pressure with the risk of premature cardiovascular disease (CVD) in adults younger than 40.

In an accompanying JAMA editorial, Vasan Ramachandran, MD, FACC, professor of medicine at Boston University School of Medicine, points out that major gaps exist in the current knowledge regarding the epidemiology, diagnosis, risk stratification and management of higher blood pressure levels in young adults.

He suggests that studies are needed to understand the causes of high blood pressure. "How social determinants of health, changes to culture, customs, diet, healthcare and the wear and tear of repeated or chronic stress are all factors that may be impacting blood pressure in young people," explained Ramachandran, who also is principal investigator and director of the Framingham Heart Study.

Ramachandran believes greater clarity is needed regarding the potential use of individual characteristics, long-term (30-year as opposed to 10-year) CVD risks and high blood pressure mediated target organ damage (to heart, kidneys and eyes) to guide treatment decisions for high blood pressure levels in young adults. "Optimal blood pressure targets in relation to plausible clinical benefit versus possible harm due to long-term blood pressure lowering need to be clearly delineated for young adults with non-normal blood pressure levels. Periodic blood pressure check-up at their doctors' office (during regular health visits) and simple lifestyle measures such as regular physical exercise and avoiding putting on excess weight are likely to be useful in young adults for maintaining optimal levels of blood pressure."

According to Ramachandran, bridging these critical knowledge gaps may help define how, when and what could be implemented to maintain an optimal blood pressure profile from childhood through young adulthood and beyond. "Answers to these questions will be a public health legacy to the current generation of children and young adults and to their future offspring."

Boston University School of Medicine

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