Study Examines High BP in Young Adults and LV Function in Middle Age

In young adults, having blood pressure that is elevated but still within normal range for long periods of time may lead to incipient left ventricular (LV) systolic and diastolic dysfunction in middle age, according to a study published June 22 in the Journal of the American College of Cardiology.

Researchers from the CARDIA study examined 2,479 men and women aged 18 to 30 years old for 25 years beginning in 1985 and 1986. Throughout the study period, seven health assessments were conducted, including blood pressure readings. The researchers calculated the cumulative exposure of blood pressure for each participant over the duration of the study. At the end of the study, researchers also used cardiac imaging to assess several measures of heart function.

Results showed that participants who had blood pressure that was on the higher end of the normal range when they were between the ages of 18 and 30 were more likely to have LV dysfunction in middle age. Researchers said their work suggests young adults should take steps to reduce elevated blood pressure by reducing sodium intake, maintaining an ideal body weight, being physically active and adhering to any recommended medical treatments for high blood pressure.

The findings provide support for the importance of good risk factor control early in life since many participants were not hypertensive at the beginning of the study; however, chronic exposure to higher blood pressure was found to be associated with cardiac dysfunction 25 years later.

"This research raises critical questions about the importance of blood pressure even earlier in life and the need for longitudinal studies beginning in childhood or youth," said Thomas H. Marwick, MD, PhD, MPH, FACC, from the Menzies Institute for Medical Research at the University of Tasmania in Australia and author of an editorial comment accompanying the study. "The ability to identify at-risk patients at an earlier age could prevent the development of heart dysfunction and failure."

Clinical Topics: Congenital Heart Disease and Pediatric Cardiology, Heart Failure and Cardiomyopathies, Prevention, CHD & Pediatrics and Prevention, CHD & Pediatrics and Quality Improvement, Hypertension

Keywords: Adolescent, Adult, Biomedical Research, Blood Pressure, Hypertension, Ideal Body Weight, Longitudinal Studies, Middle Aged, Risk Factors, Sodium, Systole, Ventricular Dysfunction, Left, Ventricular Function, Left

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