A hypertensive problem
AGE IS a risk factor for hypertension or high blood pressure, so the older a person is, the more likely he or she is to have it. But young individuals having hypertension is not entirely new.
According to a new study published last May 15 in the journal Hypertension, youngsters who are otherwise healthy but have high systolic blood pressure are at risk of a future stiffening of the artery that is linked to an increased risk of stroke and of possible damage to kidneys and brain.
The type of hypertension they have is called isolated systolic hypertension (ISH), and it affects people aged 18 to 49 with systolic blood pressure ( the first number that appears before a forward slash or fraction bar) of 140 or higher accompanied by a normal diastolic pressure (the number immediately following the slash or bar) of around 80.
The study is considered the largest ever conducted in the United States that looks at whether young, and in other respects, healthy ISH patients actually have a cardiovascular problem. According to one of the study’s authors, Dr. Wanpen Vongpatanasin, who is also the director of University of Texas (UT) Southwestern Medical Center’s Hypertension program, the research also suggests that ignoring higher-than-normal systolic blood pressure (the optimal level is under 120) may be wrong.
“I think we should consider treating these patients sooner rather than later,” she said. “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,” Dr. Vongpatanasin said.
The UT Southwestern researchers found that the threat posed by aortic stiffness is both real and visible after examining 2,001 participants in the Dallas Heart Study, which is a multiethnic population-based study of 6,101 adults in the Dallas County designed, among others, to enhance understanding of the biological basis of cardiovascular disease.
The participants had cardiovascular magnetic resonance pictures of their hearts taken. The researchers used those pictures to assess the condition of the aorta, a major artery carrying oxygenated blood from the heart to the body. Proximal aorta, a section of the aorta that leads directly to the heart, was found to be stiffened in young individuals with high systolic blood pressure.
Physicians have eschewed treating the condition in younger patients, but not in elderly ones, believing that higher systolic reading was an anomaly related to youth that would self-correct or that it was a sign of a stronger heart because it sometimes showed up in high school athletes, Dr. Vongpatanasin said.
She further remarked that their findings are important given that, at least among Americans, the incidence of isolated systolic hypertension in individuals aged 18 to 39 has more than doubled over the least two decades, and is now estimated at 5%, despite the rarity of young people having heart attacks or strokes. Dr. Vongpatanasin and her fellow researchers have a suspicion that the rising numbers may have something to do with increasing rates of obesity, which is also a risk factor for hypertension.