JAMA Cardiol: Be Alert! Unstable Blood Pressure When Young Indicates Her Future Increased Risk Of Heart Disease!

- May 03, 2020-

Inconsistent blood pressure readings in early adulthood may be an indicator of cardiovascular disease in later life.


A reliable study published in the journal JAMA Cardiology shows that in adults in their 20s and 30s, changes in blood pressure when they visit a doctor multiple times may be a warning sign.


"Current guidelines for defining high blood pressure and assessing the need for antihypertensive treatment ignore changes in blood pressure readings," Yuichiro Yano, assistant professor in the Department of Family Medicine and Community Health at Duke University in North Carolina and principal investigator of the study The doctor said. "I think there is a view that change is an accidental phenomenon, but this study shows that maybe it is not the case. On the contrary, change is very important."


What long-term data reveals


There were 3394 participants in this study. During the initial examination, blood pressure was measured 3 times every minute, and then blood pressure was measured after 2 years, 5 years, 7 years, and 10 years. The study was conducted for ten years, and the average age of the participants was 35 years. 3% of people are taking antihypertensive drugs. The researchers also conducted follow-up examinations when they were 15, 20, 25, and 30 years old.

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The researchers found that in multiple visits before the age of 40, greater variability in blood pressure was associated with a higher risk of cardiovascular disease and all-cause mortality for decades to come.


During the follow-up period, there were 162 cardiovascular events. These include: stenting of peripheral arterial disease; transient ischemic attack; stroke; heart disease; heart failure. A total of 181 people died.


The researchers suggest that assessing the variability of visiting systolic blood pressure can help identify young people at risk. Systolic blood pressure is the highest number. It represents the pressure in your arteries when your heart muscle contracts. The bottom number is the diastolic pressure, which measures the pressure generated when the arteries are elastically retracted when the human heart relaxes. Of the study participants, 54% were white and 46% were African American. Just over half are women. The study authors acknowledge that these results may not be related to other ethnic or ethnic groups.


Expert advice


Dr. Jim Liu is a cardiologist at the Ohio State University Wexner Medical Center. Liu said the study showed that changes in blood pressure may identify young people at higher risk of cardiovascular disease and cardiovascular death, regardless of their average blood pressure reading. This is a question that medical service providers need to consider. He also emphasized that more research is needed before changing habits or guidelines.


Dr. Brian Kolski is the director of the Structural Heart Disease Program at California's San Josef Hospital. He said "It is unclear why changes in systolic blood pressure may lead to an increased risk of heart disease. This study is thought-provoking because these people measure blood pressure more frequently than is common in healthy people."


Mean blood pressure


Currently, doctors use average blood pressure readings.


Liu explained that there are many factors that cause blood pressure fluctuations. This is why it is important not to use a single metric to guide management.


Liu said: "According to the latest ACC / AHA guidelines, hypertension is defined as a systolic pressure exceeding 130 mm Hg or a diastolic pressure exceeding 80 mm Hg. This should be based on more than two average readings obtained at more than two independent pressures . Young healthy adults without hypertension should have their blood pressure checked at least once a year. Patients with hypertension should have their blood pressure checked more frequently.


Liu also reminded that the blood pressure cuff should not cover the sleeve.


"There are very specific and standardized instructions on how to measure blood pressure correctly. This includes things such as taking a break before measuring blood pressure, sitting on a chair with a back support and feet on the ground for at least five minutes, emptying the bladder before measuring, and not talking during the measurement. And make sure that the cuffs are the correct size and the detection position is correct. "

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Liu said: "As long as the sphygmomanometer is verified, you can use a sphygmomanometer used in a pharmacy or home. In general, it is recommended to use the arm instead of the wrist. If used incorrectly, the wrist reading may be inaccurate. Another thing is Make sure the cuff size is correct. Too large or too small cuff may also cause inaccurate readings. "


Silent killer


Liu said that hypertension is called a "silent killer" for a reason.


Although some people may experience headaches, shortness of breath, or chest pain, most people with high blood pressure have no symptoms.


"If these symptoms occur, you should see a doctor to see if it is caused by high blood pressure."


Kolski pointed out that this may prompt your doctor to investigate secondary causes of high blood pressure, such as kidney disease or thyroid disease. For young people whose blood pressure is not within the normal range, the doctor may first advise them to change their lifestyle and diet. If you still cannot control, you can add drugs.


Kolski said: "This may be the only conclusion from this study that normal young people should check their blood pressure at least once a year."

 ( source:Bioon.com)