Key result
Hypertension onset before age 35 is linked to ~2.4-fold higher odds of LVH.
Why the study?
Although objectively defined early onset hypertension is a strong risk factor for CVD, it was unknown whether self-reported hypertension onset age is associated with hypertension-mediated organ damage.
Is self-reported early age of hypertension onset associated with increased odds of hypertension-mediated organ damage in middle-aged adults compared to no self-reported hypertension?
Cohort (n=2,649)
Yes
Is self-reported early age of hypertension onset associated with increased odds of hypertension-mediated organ damage in middle-aged adults compared to no self-reported hypertension?
Self-reported age of hypertension onset shows 78-79% agreement with objective measurements and strongly identifies middle-aged patients with early-onset hypertension (<35 years) who are at markedly elevated risk for subclinical target organ damage.
Answers are grounded in this paper and cite their sources.
May warrant closer monitoring for subclinical damage; hypothesis-generating for causal and interventional studies.
BACKGROUND: Objectively defined early onset hypertension, based on repeated blood pressure measurements, is a strong risk factor for cardiovascular disease (CVD). We aimed to assess if also self-reported hypertension onset age is associated with hypertension-mediated organ damage (HMOD). Additionally, we evaluated the agreement between self-reported and objectively defined hypertension onset age. METHODS: We studied 2,649 participants (50 ± 4 years at the time of outcome assessment, 57% women) of the Coronary Artery Risk Development in Young Adults (CARDIA) study who underwent measurements for echocardiographic left ventricular hypertrophy (LVH), left ventricular diastolic dysfunction (LVDD), coronary calcification, and albuminuria. We divided the participants into groups according to self-reported hypertension onset age (<35 years, 35-44 years, ≥45 years, and no hypertension). We used multivariable-adjusted logistic regression models to assess the relation between self-reported hypertension onset age with the presence of HMOD, with those who did not report hypertension as the referent group. RESULTS: Compared with individuals without self-reported hypertension, self-reported hypertension onset at <35 years was associated with LVH (odds ratio (OR), 2.38; 95% confidence interval (CI), 1.51-3.76), LVDD (OR, 2.32; 95% CI, 1.28-4.18, coronary calcification (OR, 2.87; 95% CI, 1.50-5.47), and albuminuria (OR, 1.62; 95% CI, 0.81-3.26). Self-reported hypertension onset at ≥45 years was only associated with LVDD (OR, 1.81; 95% CI, 1.06-3.08). The agreement between self-reported and objectively defined hypertension onset age groups was 78-79%. CONCLUSIONS: Our findings suggest that self-reported hypertension onset age, a pragmatically feasible assessment in clinical practice, is a reasonable method for assessing risk of HMOD and CVD.
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Suvila et al. (2020) conducted a cohort in Hypertension and hypertension-mediated organ damage (n=2,649). Self-reported early-onset hypertension (<35 years of age) vs. No self-reported hypertension was evaluated on Echocardiographic left ventricular hypertrophy (LVH) at Year 25 (OR 2.38, 95% CI 1.51-3.76, p=<0.001). Self-reported hypertension onset at <35 years was significantly associated with left ventricular hypertrophy (OR 2.38, 95% CI 1.51-3.76), diastolic dysfunction, and coronary calcification.
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