Early Onset Hypertension Is Associated With Hypertensive End-Organ Damage Already by MidLife
Early onset hypertension confers increased risk for cardiovascular mortality in the community. Whether early onset hypertension also promotes the development of target end-organ damage (TOD), even by midlife, has remained unknown. We studied 2680 middle-aged CARDIA study (Coronary Artery Risk Develo...
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Published in | Hypertension (Dallas, Tex. 1979) Vol. 74; no. 2; pp. 305 - 312 |
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Main Authors | , , , , , , |
Format | Journal Article |
Language | English |
Published |
United States
American Heart Association, Inc
01.08.2019
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Subjects | |
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Abstract | Early onset hypertension confers increased risk for cardiovascular mortality in the community. Whether early onset hypertension also promotes the development of target end-organ damage (TOD), even by midlife, has remained unknown. We studied 2680 middle-aged CARDIA study (Coronary Artery Risk Development in Young Adults) Study participants (mean age 50±4 years, 57% women) who underwent up to 8 serial blood pressure measurements between 1985 and 2011 (age range at baseline 18–30 years) in addition to assessments of echocardiographic left ventricular hypertrophy, coronary calcification, albuminuria, and diastolic dysfunction in 2010 to 2011. Age of hypertension onset was defined as the age at first of 2 consecutively attended examinations with blood pressure ≥140/90 mm Hg or use of antihypertensive medication. Participants were divided in groups by hypertension onset age (<35 years, 35–44 years, ≥45 years, or no hypertension). While adjusting for TOD risk factors, including systolic blood pressure, we used logistic regression to calculate odds ratios for cases (participants with TOD) versus controls (participants without TOD) to examine the relation of hypertension onset age and hypertensive TOD. Compared with normotensive individuals, hypertension onset at age <35 years was related to odds ratios of 2.29 (95% CI, 1.36–3.86), 2.94 (95% CI, 1.57–5.49), 1.12 (95% CI, 0.55–2.29), and 2.06 (95% CI, 1.04–4.05) for left ventricular hypertrophy, coronary calcification, albuminuria, and diastolic dysfunction, respectively. In contrast, hypertension onset at age ≥45 years was not related to increased odds of TOD. Our findings emphasize the importance of assessing age of hypertension onset in hypertensive patients to identify high-risk individuals for preventing hypertensive complications. |
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AbstractList | Early onset hypertension confers increased risk for cardiovascular mortality in the community. Whether early onset hypertension also promotes the development of target end-organ damage (TOD), even by midlife, has remained unknown. We studied 2680 middle-aged CARDIA study (Coronary Artery Risk Development in Young Adults) Study participants (mean age 50±4 years, 57% women) who underwent up to 8 serial blood pressure measurements between 1985 and 2011 (age range at baseline 18–30 years) in addition to assessments of echocardiographic left ventricular hypertrophy, coronary calcification, albuminuria, and diastolic dysfunction in 2010 to 2011. Age of hypertension onset was defined as the age at first of 2 consecutively attended examinations with blood pressure ≥140/90 mm Hg or use of antihypertensive medication. Participants were divided in groups by hypertension onset age (<35 years, 35–44 years, ≥45 years, or no hypertension). While adjusting for TOD risk factors, including systolic blood pressure, we used logistic regression to calculate odds ratios for cases (participants with TOD) versus controls (participants without TOD) to examine the relation of hypertension onset age and hypertensive TOD. Compared with normotensive individuals, hypertension onset at age <35 years was related to odds ratios of 2.29 (95% CI, 1.36–3.86), 2.94 (95% CI, 1.57–5.49), 1.12 (95% CI, 0.55–2.29), and 2.06 (95% CI, 1.04–4.05) for left ventricular hypertrophy, coronary calcification, albuminuria, and diastolic dysfunction, respectively. In contrast, hypertension onset at age ≥45 years was not related to increased odds of TOD. Our findings emphasize the importance of assessing age of hypertension onset in hypertensive patients to identify high-risk individuals for preventing hypertensive complications. |
Author | Ebinger, Joseph E Niiranen, Teemu J Lima, Joao A.C Cheng, Susan Suvila, Karri McCabe, Elizabeth L Lehtonen, Arttu |
AuthorAffiliation | From the Division of Medicine, Turku University Hospital (K.S., T.J.N.), University of Turku, Finland Department of Geriatrics (A.L.), University of Turku, Finland Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston (E.L.M., S.C.) Smidt Heart Institute, Cedars-Sinai Medical Center Los Angeles, CA (J.E.E., S.C.) Division of Cardiology, Johns Hopkins University, Baltimore, MD (J.A.C.L.) Framingham Heart Study, MA (S.C.) Department of Public Health Solutions, National Institute for Health and Welfare, Turku, Finland (T.J.N.) |
AuthorAffiliation_xml | – name: From the Division of Medicine, Turku University Hospital (K.S., T.J.N.), University of Turku, Finland Department of Geriatrics (A.L.), University of Turku, Finland Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston (E.L.M., S.C.) Smidt Heart Institute, Cedars-Sinai Medical Center Los Angeles, CA (J.E.E., S.C.) Division of Cardiology, Johns Hopkins University, Baltimore, MD (J.A.C.L.) Framingham Heart Study, MA (S.C.) Department of Public Health Solutions, National Institute for Health and Welfare, Turku, Finland (T.J.N.) |
Author_xml | – sequence: 1 givenname: Karri surname: Suvila fullname: Suvila, Karri organization: From the Division of Medicine, Turku University Hospital (K.S., T.J.N.), University of Turku, Finland Department of Geriatrics (A.L.), University of Turku, Finland Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston (E.L.M., S.C.) Smidt Heart Institute, Cedars-Sinai Medical Center Los Angeles, CA (J.E.E., S.C.) Division of Cardiology, Johns Hopkins University, Baltimore, MD (J.A.C.L.) Framingham Heart Study, MA (S.C.) Department of Public Health Solutions, National Institute for Health and Welfare, Turku, Finland (T.J.N.) – sequence: 2 givenname: Elizabeth surname: McCabe middlename: L fullname: McCabe, Elizabeth L – sequence: 3 givenname: Arttu surname: Lehtonen fullname: Lehtonen, Arttu – sequence: 4 givenname: Joseph surname: Ebinger middlename: E fullname: Ebinger, Joseph E – sequence: 5 givenname: Joao surname: Lima middlename: A.C fullname: Lima, Joao A.C – sequence: 6 givenname: Susan surname: Cheng fullname: Cheng, Susan – sequence: 7 givenname: Teemu surname: Niiranen middlename: J fullname: Niiranen, Teemu J |
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