Key result
Compared to normal blood pressure, stage 1 and stage 2 hypertension were associated with increased risk of incident cardiovascular disease (HR 1.45, 95% CI 1.26-1.68 and HR 2.12, 95% CI 1.74-2.58).
Why the study?
Outcome studies of hypertension in young adults are limited, particularly using the new ACC/AHA blood pressure categories.
Are higher blood pressure categories, as defined by the ACC/AHA 2017 guidelines, associated with an increased risk of incident cardiovascular disease in low-risk young adults compared to normal blood pressure?
Cohort (n=244,837)
No
Are higher blood pressure categories, as defined by the ACC/AHA 2017 guidelines, associated with an increased risk of incident cardiovascular disease in low-risk young adults compared to normal blood pressure?
Hazard Ratio: 1.45 (95% CI 1.26–1.68)
In low-risk young adults, all categories of higher blood pressure defined by the 2017 ACC/AHA guidelines are independently associated with an increased risk of incident cardiovascular disease.
May support BP monitoring in young adults; leaves open whether early intervention reduces CVD events.
Background There are limited outcome studies of hypertension among young adults, especially using the new blood pressure ( BP ) categories from the American College of Cardiology and the American Heart Association. We examined associations between the new BP categories and the risk of incident cardiovascular disease ( CVD ) in low‐risk and young adults. Methods and Results A cohort study was performed in 244 837 Korean adults (mean age, 39.0 years; SD , 8.9 years) who underwent a comprehensive health examination at Kangbuk Samsung Hospital from January 1, 2011, to December 31, 2016; they were followed up for incident CVD via linkage to the Health Insurance and Review Agency database until the end of 2016, with a median follow‐up of 4.3 years. BP was categorized according to the new American College of Cardiology/American Heart Association (ACC/AHA) hypertension guidelines. During 924 420.7 person‐years, 1435 participants developed new‐onset CVD (incidence rate of 16.0 per 10 4 person‐years). The multivariable‐adjusted hazard ratios (95% CI s ) for CVD comparing elevated BP , stage 1 hypertension, stage 2 hypertension, treated and strictly controlled (systolic BP /diastolic BP <130/80 mm Hg with antihypertensive use), treated and controlled (systolic BP 130–139 and diastolic BP 80 to 89 mm Hg with antihypertensive use), treated uncontrolled, and untreated hypertension to normal BP were 1.37 (1.11–1.68), 1.45 (1.26–1.68), 2.12 (1.74–2.58), 1.41 (1.12–1.78), 1.97 (1.52–2.56), 2.29 (1.56–3.37) and 1.93 (1.53–2.45), respectively. Conclusions In this large cohort of low‐risk and young adults, all categories of higher BP were independently associated with an increased risk of CVD compared with normal BP , underscoring the importance of BP management even in these low‐risk populations.
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Kim et al. (2019) conducted a cohort in Hypertension (n=244,837). Higher blood pressure categories (ACC/AHA 2017 guidelines) vs. Normal blood pressure was evaluated on Incident cardiovascular disease (CVD) (HR 1.45, 95% CI 1.26-1.68). Compared to normal blood pressure, stage 1 and stage 2 hypertension were associated with increased risk of incident cardiovascular disease (HR 1.45, 95% CI 1.26-1.68 and HR 2.12, 95% CI 1.74-2.58).