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For Young Adults, Borderline High Blood Pressure a Threat

Study says it leads to damaged heart arteries later in life

MONDAY, July 14 (HealthDay News) -- Young adults with the borderline high blood pressure called prehypertension are more likely later in life to have calcium deposits in their coronary arteries, a new study finds.

"They're too young to have very many heart attacks and strokes," lead author Dr. Mark J. Pletcher said of the 3,560 participants whose ages were 18 to 30 when the study started. "But looking at coronary calcium is a way of measuring atherosclerosis, which is a strong predictor of heart attacks."

Almost 20 percent of the people in the study developed prehypertension -- which is blood pressure higher than the recommended 120 over 80 but below the 140 over 80 reading of treatable high blood pressure -- before the age of 35. Coronary scans showed accumulation of calcium deposits in their heart arteries during the 20-year study.

"What we have shown is that these low-level elevations, above 120 over 80, appear to be associated with atherosclerosis later in life and probably with heart attacks and stroke," said Pletcher, an assistant professor of epidemiology, biostatistics and medicine at the University of California, San Francisco.

The findings were published in the July 15 issue of the Annals of Internal Medicine.

"This is another bit of evidence that we should pay attention to prehypertension in young people," said Dr. Richard B. Devereux, professor of medicine at Weill Cornell Medical College in New York City. He led a study several years ago of American Indians that found an association between prehypertension in early adulthood and abnormalities of the heart muscles.

"They used a totally different bioassay," Devereux said of the San Francisco researchers. "It helps flesh out a more complete story."

Prehypertension early in life is associated not only with development of atherosclerosis, the formation of plaques that can eventually block arteries, but also with arteriosclerosis, stiffening of the arteries, Devereux said.

The new study found hypertension more common in men, blacks, and people who were overweight and of low socioeconomic status. Participants with annul incomes below $25,000 and no college education were twice as likely to have early prehypertension as those with annual incomes of more than $100,000 and a postgraduate education.

Drug treatment isn't a real option for prehypertension in young people, Pletcher said. "We don't have evidence that treating prehypertension in young adulthood prevents cardiovascular disease, so we don't recommend it," he said.

But physicians should pay attention to borderline high blood pressure in young people, and should recommend preventive measures if it is found, Pletcher said.

"We recommend lifestyle modifications, more exercise, better diet, and so on, to improve cardiovascular health," he said.

Devereux agreed. "Exercise, better diet, getting away from smoking, avoiding things which can be damaging to the arteries," he advised.

More information

Learn more about high blood pressure and prehypertension from the U.S. National Library of Medicine.

SOURCES: Mark J. Pletcher, M.D., assistant professor, epidemiology, biostatistics and medicine, University of California, San Francisco; Richard B. Devereux, M.D., professor, medicine, Weill Cornell Medical College, New York City; July 15, 2008, Annals of Internal Medicine

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