New-onset hypertension was associated with increased risk of cardiovascular disease and mortality, with the strongest risk observed in patients with onset age <45 years (CVD HR 2.26; 95% CI 1.19-4.30).
Case-Control (n=71,245)
No
Does a younger age of hypertension onset increase the risk of cardiovascular diseases and all-cause mortality compared to older onset or normotension?
Younger age of hypertension onset is associated with a substantially higher relative risk of cardiovascular disease and all-cause mortality, highlighting the importance of early blood pressure management.
Effect estimate: HR 2.26 (95% CI 1.19-4.30)
BACKGROUND The relations of hypertension onset age with cardiovascular diseases (CVD) and all-cause mortality remain inconclusive. OBJECTIVES This study sought to examine the associations of hypertension onset age with CVD and all-cause mortality. METHODS This prospective study included 71,245 participants free of hypertension and CVD in the first survey (July 2006 to October 2007) of the Kailuan study, a prospective cohort study in Tangshan, China. All participants were followed biennially until December 31, 2017. A total of 20,221 new-onset hypertension cases were identified during follow-up. We randomly selected 1 control participant for each new-onset hypertensive participant, matching for age (±1 year) and sex, and included 19,887 case-control pairs. We used weighted Cox regression models to calculate the average hazard ratios of incident CVD and all-cause mortality across the age groups. RESULTS During an average follow-up of 6.5 years, we identified 1,672 incident CVD cases and 2,008 deaths. After multivariate adjustment, with the increase in hypertension onset age, the hazards of outcomes were gradually attenuated. The average hazard ratio (95% confidence interval) of CVD and all-cause mortality were 2.26 (1.19 to 4.30) and 2.59 (1.32 to 5.07) for the hypertension onset age <45 years old group, 1.62 (1.24 to 2.12) and 2.12 (1.55 to 2.90) for the 45- to 54-year age group, 1.42 (1.12 to 1.79) and 1.30 (1.03 to 1.62) for the 55- to 64-year age group, and 1.33 (1.04 to 1.69) and 1.29 (1.11 to 1.51) for the ≥65-year age group, respectively (p for interaction = 0.38 for CVD and <0.01 for death). CONCLUSIONS Hypertension was associated with a higher risk for CVD and all-cause mortality, and the associations were stronger with a younger age of onset.
“It is no surprise that hypertension beginning in young adults and early middle age results in a higher risk for cardiovascular disease and death than in older people. The challenge is to provide health literacy in elementary school and emphasize the seriousness of hypertension to young adults, particularly those with a family history of hypertension and CVD and social determinants that place them at highest risk.”
Wang et al. (Mon,) conducted a case-control in Hypertension (n=71,245). New-onset hypertension vs. Matched normotensive controls was evaluated on Incident cardiovascular diseases (HR 2.26, 95% CI 1.19-4.30). New-onset hypertension was associated with increased risk of cardiovascular disease and mortality, with the strongest risk observed in patients with onset age <45 years (CVD HR 2.26; 95% CI 1.19-4.30).