Early-onset hypertension tied to end-organ damage by midlife

  • Hypertension

  • International Clinical Digest
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Takeaway

  • Early-onset hypertension before age 35 years is strongly linked to higher risk for left ventricular (LV) hypertrophy and diastolic dysfunction, and coronary calcification by midlife.
  • A quarter of people with early-onset hypertension have target end-organ damage in 2+ organs.

Why this matters

  • The authors say their results underscore the importance of discerning age of hypertension onset so that measures can be taken to prevent complications.

Key results

  • At a mean age of 50±4 years, individuals with hypertension onset at age
    • LV hypertrophy: 2.29 (1.36-3.86);
    • Coronary calcification: 2.94 (1.57-5.49); 
    • Albuminuria: 1.12 (0.55-2.29); and 
    • LV diastolic dysfunction: 2.06 (1.04-4.05).
  • Target end-organ damage rates:
    • Normotensive: 23.7% (4.6% in 2+ organs).
    • Onset at age
  • Associations were not seen for people with onset ≥45 years.

Study design

  • 2680 participants from the Coronary Artery Risk Development In Young Adults (CARDIA) study (baseline age range, 18-30 years).
  • Hypertension at time of measurements defined as ≥140/90 mmHg or use of antihypertensives.
  • Adjustments made for cardiovascular risk factors.
  • Funding: None disclosed.

Limitations

  • 68.4% of those with baseline measures remained available for final assessment.
  • Intensity of antihypertensive therapy not captured.