Blood pressure in young adulthood and mortality from cardiovascular disease

doi:10.1016/S0140-6736(00)02146-2

The Lancet

Volume 355, Issue 9213, 22 April 2000, Pages 1430-1431

https://doi.org/10.1016/S0140-6736(00)02146-2 Get rights and content

Blood pressure measured in young adult men is positively associated in later life with increased cardiovascular disease mortality. The implication of this finding is that risk of cardiovascular disease starts in early life.

References (5)

RS Paffenbarger et al.
Characteristics in youth predisposing to fatal stroke in later years
Lancet
(1967)
P McCarron et al.
Life course exposure and later disease: a follow-up study based on medical examinations carried out in Glasgow University (1948–68)
Public Health
(1999)

There are more references available in the full text version of this article.

Cited by (143)

Premature coronary heart disease complicated with hypertension in hospitalized patients: Incidence, risk factors, cardiovascular-related comorbidities and prognosis, 2008–2018
2024, International Journal of Cardiology: Cardiovascular Risk and Prevention
The clinical characteristics and risk factors of all-cause mortality in young hospitalized patients with comorbid coronary heart disease and hypertension (CAD + HT) are not well-characterized.
A total of 2288 hospitalized CAD patients (age<45 years) with or without hypertension in the Chinese PLA General Hospital from August 5, 2008 to June 22, 2018 were conducted. The risk factors of all-cause mortality were estimated in young CAD + HT patients by COX models.
The overall prevalence of hypertension in young CAD patients was 50.83% (n = 1163). CAD + HT patients had older age, higher heart rate, BMI, uric acid, triglyceride and lower level of eGFR and HDL-C than CAD patients (P < 0.05). The proportion of cardiovascular-related comorbidities (including obesity, diabetes mellitus, hyperuricemia and chronic kidney disease [CKD]) in the CAD + HT group was significantly higher than that in CAD group (P < 0.0001). The risk of all-cause mortality was higher in CAD + HT patients, although after adjusting for all covariates, there was no significant difference between the two groups. Furthermore, CKD (HR, 3.662; 95% CI, 1.545–8.682) and heart failure (HF) (HR, 3.136; 95%CI, 1.276–7.703) were associated with an increased risk of all-cause mortality and RAASi (HR, 0.378; 95%CI, 0.174–0.819) had a beneficial impact in CAD + HT patients.
Hypertension was highly prevalent in young CAD patients. Young CAD + HT patients had more cardiovascular metabolic risk factors, more cardiovascular-related comorbidities and higher risk of all-cause mortality. CKD and HF were the risk factors, while RAASi was a protective factor, of all-cause mortality in CAD + HT patients.
Hypertension in Athletes: Clinical Implications and Management Strategies
2023, Cardiology Clinics
Citation Excerpt :
With aging, as observed in the general population, the prevalence of hypertension in athletes increases. It is well established that the presence of CV risk factors in young adults, particularly hypertension, is associated with later-life CV morbidity and mortality.8–10 Independent of other established CV risk factors, the potency of increased BP on outcomes has been established, predicting incident atherosclerotic cardiovascular disease (ASCVD) and early, adverse CV outcomes.11
Depression duration and risk of incident cardiovascular disease: A population-based six-year cohort study
2022, Journal of Affective Disorders
Depression symptoms are significantly associated with an increased risk of cardiovascular disease (CVD). However, understanding of the magnitude of the association between depression duration and risk of CVD is limited. Therefore, we aimed to assess whether a longer duration of exposure to depression is associated with a higher risk of new-onset CVD.
We conducted a territory-wide retrospective cohort study among patients (≥ 10 years old) with depression diagnosed between January and December 2014 in Hong Kong. The observation period spanned January 1, 2014, to December 31, 2019, and all participants had no CVD at baseline. Incidence of CVD was calculated. We used Cox proportional hazard regression to adjust confounders and estimate hazard ratios of CVD risk.
Among 11,651 participants with depression, 1306 (11.2%) individuals developed CVD. Multi-adjusted models showed individuals with depression duration of 2–5 years (Hazard Ratios [HRs]: 1.38 [95% confidence interval (CI): 1.19–1.60]) and ≥6 years (1.45 [1.25–1.68]) had a significantly escalated risk of developing CVD, compared to those with depression within one year. Stratified analyses indicated that the association was prominent in women and those under 65 years old.
Lack of depression severity information and the small sample size in some subgroup analyses.
Longer exposure to depression is associated with significant increased risk of CVD. The interplay between mental and vascular health emphasizes the need for CVD prevention in patients with long-term depression.
Acute responses of airway oxidative stress, inflammation, and hemodynamic markers to ambient PM<inf>2.5</inf> and their trace metal contents among healthy adolescences: A panel study in highly polluted versus low polluted regions
2021, Environmental Pollution
Particulate air pollutants are known contributors to global cardiorespiratory mortality through several pathways. We examined the effects of varied exposure to PM_2.5 and trace metals on biological markers of airway inflammation, oxidative stress, and hemodynamic function of young individuals living in two different exposure settings.
We enrolled and followed a panel of 97 healthy nonsmoking participants aged 15–18 years living in a highly polluted metropolitan city of Tabriz (TBZ) and a much less polluted semi-urban town of Hadishahr (HDS). For five consecutive months, the subjects were examined by a physician, and fractional exhaled nitric oxide levels (FE_NO) were measured. Samples of exhaled breath condensation (EBC) were obtained for measuring interleukin 6 (IL-6), tumor necrosis factor α (TNF-α), and total nitric oxide (NO_x). We measured daily outdoor PM_2.5 mass concentration in a fixed station in each location for all this period. The PM-metal content was analyzed by ICP-MS. The linear mixed-effects regression models were applied for data analysis.
The averages of PM_2.5 mass and total metals in TBZ were nearly two and four times higher than in HDS, respectively. In TBZ, an increased IQR of PM_2.5 mass during 0–5 days was -correlated with a significant rise in diastolic blood pressure, heart rate, TNF-α, FE_NO, and NO_x and reduction of IL-6. Moreover, exposure to low PM_2.5 concentration is significantly -correlated with an elevation in diastolic blood pressure in HDS. We also observed that exposure to metal constituents in the highly polluted region is correlated with increased TNF-α and IL-6 with 131.80% (95% CI: 56.01, 244.39) and 47.51% (95% CI: 33.01, 62.05) per IQR of Hg, respectively.
This study suggests that exposure to ambient PM_2.5 and their metal contents in highly polluted areas may incite significant changes in airway inflammation, oxidative stress, and hemodynamic parameters in healthy subjects.
Changes in the prevalence of obesity and hypertension and demographic risk factor profiles in China over 10 years: two national cross-sectional surveys
2021, The Lancet Regional Health - Western Pacific
Citation Excerpt :
In addition, we found that young adults had a greater increase in SBP levels than somewhat older individuals. Trends in blood pressure levels in young adults are a marker of the future population burden of cardiovascular disease and may be particularly relevant in areas with high disease rates.[32] This phenomenon might be partially explained by the fact that in the Chinese population, the later the year in which an individual was born is, the higher their risk of developing hypertension is; while the development of the economy has gradually improved the standard of living of the Chinese people, the burdens of work and stress have increased.[13]
Previous studies have shown increases in the prevalence of obesity and hypertension, but nationally representative data on recent changes in prevalence adjusted for population structure changes are lacking. Two nationwide surveys were conducted in 2007 and 2017 to assess the prevalence changes of these conditions in China.
A multistage stratified random sampling method was used to obtain a nationally representative sample of adults aged 20 years and older in mainland China in 2007 and 2017. Temporal changes in the prevalence of hypertension and obesity were investigated. Changes in blood pressure, body mass index (BMI) and waist circumference were also assessed. Logistic regression models were constructed to assess the changes in prevalence over time.
The weighted prevalence of hypertension (25.7% vs. 31.5%, P=0.04), high-normal blood pressure (11.7% vs. 14.3%, P<0.0001), general obesity (31.9% vs. 37.2%, P=0.008), and central obesity (25.9% vs. 35.4%, P=0.0002) was significantly higher in 2017 (n=72824) than in 2007 (n=45956) in the overall population. No significant changes in the prevalence of overweight and grade 1 or grade 2 hypertension were observed in the overall population, but a significantly higher prevalence was observed among participants aged 20-29 years for grade 1 hypertension (P=0.002) and among participants aged 70 years and older for grade 2 hypertension (P=0.046) in 2017.
Compared with 2007, the prevalence of hypertension and obesity was significantly higher among adults in mainland China after adjusting for demographic confounding factors in 2017. More targeted interventions and prevention strategies are needed to offset the increasing risk of cardiovascular disease due to increases in the prevalence of hypertension and obesity.
The Clinical Research Fund of the Chinese Medical Association (Grant No. 15010010589), the National Natural Science Foundation of China (Grant No. 82000753), and the Chinese Medical Association Foundation and Chinese Diabetes Society (Grant No. 07020470055)
Pregnancy - An Ideal Period to Identify Women at Risk for Chronic Hypertension
2024, Hypertension

View all citing articles on Scopus

View full text

Research LettersBlood pressure in young adulthood and mortality from cardiovascular disease

Lancet

Public Health

Research Letters
Blood pressure in young adulthood and mortality from cardiovascular disease