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TUESDAY, Nov. 6, 2018 (HealthDay News) – Two new studies suggest that when people under 40 develop high blood pressure, their risk of heart disease and early stroke increases dramatically.
The first study found that in a group of about 5,000 young American adults, high blood pressure was associated with a 3.5 times higher risk of heart disease and stroke.
The second study involved nearly 2.5 million young Korean adults and also found that high blood pressure in young people increased the risk of heart disease and premature stroke by 85%.
Both studies supported new blood pressure recommendations from the American College of Cardiology and the American Heart Association. These guidelines set a lower threshold for what is considered high blood pressure. Stage 1 hypertension begins when blood pressure is greater than 130/80 mmHg; it is considered Stage 2 hypertension if it exceeds 140/90 mm Hg.
There has been some debate as to whether these new guidelines are too stringent and they have not been universally adopted. For example, they are not yet used in Europe.
However, the lead author of the first study, Dr. Yuichiro Yano of Duke University, said their findings show that "the new guidelines for blood pressure can help identify young adults presenting a higher risk of cardiovascular events and all-cause mortality, the guidelines seem reasonable. "
According to the new guidelines, normal blood pressure should be less than 120 (systolic) / less than 80 (diastolic).
The co-author of the publication, Gregory Curfman, deputy chief editor of the Journal of the American Medical Association, said the results of two studies involving two very different populations are "very strong evidence" that the new guidelines identify the disturbing high blood pressure in adults under 40 years old.
What is surprising in the new guidelines is the high number of people with high blood pressure when the lower threshold is used. In the United States, the new guidelines mean that 46% of Americans suffer from high blood pressure, up 32%. In China, the number is now 50%, up 25%. And in India, it is now 43%, against 29% previously, according to the editorial.
One of the reasons why these rates can be so high is that high blood pressure often has no symptoms.
Dr. Naomi Fisher of Harvard Medical School, co-author of Curfman, said, "For many patients, high blood pressure is an abstract disease." Unlike a fracture or a headache, the 39, hypertension is almost impossible to visualize or locate.Add that it rarely causes It often takes years for its symptoms, such as a heart attack or stroke, to occur and it is easy to understand why the may underestimate the importance of controlling high blood pressure. "
But Fisher said that people can do a lot to control blood pressure.
"We need to mobilize our patients and help them understand the power they have to control their health," she said.
One step is to regularly monitor blood pressure at home. People suffering from high blood pressure also need to "prioritize healthy lifestyle changes. Even with medication, a healthy lifestyle is essential for controlling hypertension. It means a healthy diet and a healthy weight, reduced sodium intake [salt] drinking and regular physical activity, "said Fisher.
"This work is difficult," she added, "but it's worth it."
Yano noted that if young people with high blood pressure could lower it, the risk of heart disease and stroke could also decrease.
The people participating in Yano's study were on average 36 years old at the beginning of the study. The study group was almost equally divided between whites and blacks. About 230 people had a heart attack, stroke, or heart failure during the nearly 19-year follow-up period.
People with high blood pressure (120-129 / under 80 mmHg) had a higher risk of heart disease or stroke (67%). People with stage 1 hypertension (130/80 and above) had a 75% higher risk, and those with stage 2 hypertension (140/90 and above) had a risk 3, 5 times higher heart disease or stroke compared to someone with normal blood pressure, the study found.
In the Korean study, the average age was 31 years old. Nearly 45,000 cardiovascular events (heart disease or stroke) were reported during the average 10-year follow-up of the study. Young adults with Stage 1 arterial hypertension had a higher risk of heart disease or stroke by about 25% compared to those whose readings were normal. For people with stage 2 hypertension, the risk of heart disease or stroke was 76% higher in men and 85% higher in women.
The results of both studies were published in the November 6 issue of Journal of the American Medical Association.
More information
Learn more about the management of high blood pressure of the American Heart Association.
SOURCES: Yuichiro Yano, M.D., Ph.D., Assistant Professor, Department of Community and Family Medicine, Duke University, Durham, N .; Gregory Curfman, M.D., Assistant Editor, Journal of the American Medical Association; Naomi Fisher, MD, Director of Hypertension and Hypertension Innovation, and Associate Professor of Medicine at Harvard Medical School, Boston; November 6, 2018, Journal of the American Medical Association
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