Twenty-somethings with even
mildly elevated blood pressure may face an increased risk of clogged heart
arteries by middle age, a long-term US study finds.
The study, which tracked
nearly 4 700 people, found that even "pre-hypertension" in young
adulthood was linked to a higher risk of calcium build-up in the heart arteries
25 years later.
Experts said the findings
send a message to young adults: Know your blood pressure numbers and, if
needed, change your lifestyle to get them in the normal range.
Lifestyle changes 'enough'
"What you do as a
young adult matters," said lead researcher Norrina Allen, an assistant
professor of preventive medicine at Northwestern University Feinberg School of
Medicine, in Chicago. "We shouldn't wait until middle-age to address blood
That same message goes for
doctors, too, Allen added. "Many doctors might not think a small elevation
in blood pressure (in a young adult) even warrants a discussion," she
The good news, Allen noted,
is that lifestyle changes can "absolutely" be enough for a healthy
young person with moderately elevated blood pressure.
Diet changes, such as
cutting out salty processed foods and getting more fruits and vegetables, are
key. So is moderate exercise, like walking, study author Allen said. And if
you're overweight, even cutting a few pounds can help lower blood pressure.
Bakris pointed to some
steps that are less well known: Watch your drinking, since alcohol can raise
blood pressure; and get enough sleep.
"It's important to get
at least six hours of uninterrupted sleep each night," Bakris said.
"Ideally, you'd get six to eight hours."
In the United States, about
one-third of adults have high blood pressure, which is defined as a systolic
pressure (the top number) of 140 or higher, or a diastolic pressure (the bottom
number) of 90 or higher, according to the US Centres for Disease Control and
Prevention. "Normal" blood pressure is anything below 120/80, while
numbers that fall in between "normal" and "high" are
What findings suggest
The new findings are based
on 4,681 people from four U.S. cities who were between the ages of 18 and 30
when they entered the study in the mid-1980s. Over the next couple of decades,
they had their blood pressure taken periodically. At year 25, they underwent CT
scans to look for calcium build-up in the arteries – which is considered an
early sign of heart disease.
Overall, Allen's team found
that study participants had five general "trajectories" in blood
pressure over time.
5% had slightly
elevated blood pressure at their first measurement, which then kept increasing
over the years. That group had the worst-looking arteries 25 years later:
One-quarter had calcium "scores" above 100, which is linked to a
higher-than-normal risk of suffering a heart attack in the next several years.
In contrast, among people
who had normal blood pressure throughout the study, only 4% had calcium
scores that high.
But it wasn't only the
young people with ever-increasing blood pressure who showed artery trouble
Another 19% had
blood pressure that was slightly elevated in young adulthood, but stable
thereafter – hovering in the pre-hypertension range over the years. In that
group, 17% ended up with a calcium score above 100.
Of course, young people
with elevated blood pressure might have other health issues, too. But even when
Allen's team took into account for other factors – like smoking, weight and current
blood pressure – a person's lifetime blood-pressure pattern was still
Don't wait too long
According to Bakris, it all
suggests that elevated blood pressure, left unchecked, can start taking a toll
on the arteries early in life. "If you wait until your 40s or 50s to
address it, the damage to the arteries may already be done," he said.
He suggested that most
healthy young people have their blood pressure checked every couple of years.
But if they have a strong family history of high blood pressure – such as two
parents who developed the condition at a fairly young age – more-frequent
blood pressure checks would be in order, Bakris said.
Hypertension in young adults often undiagnosed
Being fit cuts hypertension risk