High blood pressure, also known as hypertension, is a common but silent health problem that affects millions of people around the world. Often without noticeable symptoms, this condition increases the force of blood against the walls of your arteries, potentially leading to serious health complications over time, such as heart disease, stroke, and kidney failure.
A recent study published in the Journal of Pediatrics highlights the detrimental effects of high blood pressure and hypertension during adolescence, leading to early heart damage that is exacerbated in young adulthood. This collaborative research effort between the University of Bristol (UK) and the University of Eastern Finland highlights the importance of addressing blood pressure issues early in life to prevent possible long-term health complications.
High blood pressure and hypertension, often referred to as “silent killer diseases” in adults, are known to cause damage to the kidneys, heart, blood vessels and brain, ultimately leading to death. The global cost of treating hypertension amounts to billions of dollars each year and is linked to an increasing number of health emergencies, including heart attacks and strokes.
The European Society of Cardiology/European Society of Hypertension classifies blood pressure 130/85 mmHg as high normal and 140/90 mmHg as hypertension. While the American College of Cardiology/American Heart Association classifies blood pressure of 130/80 mmHg as hypertension.
High blood pressure and hypertension can cause premature heart damage in young people. Blood pressure screening and prevention is urgently needed in the young population. Credit: Andrew Agbaje
In 2020, the U.S. Preventive Services Task Force concluded: “that the evidence to support screening for high blood pressure in children and adolescents is insufficient and that the balance between benefits and disadvantages cannot be determined”.
However, it was reported last year (2022) that an increase in systolic blood pressure during childhood was associated with the risk of premature death in the mid-40s. Nevertheless, the earliest time revealing of potential heart damage related to arterial hypertension in a general population of children and adolescents remains unknown.
Additionally, it is unclear whether hypertension above 130/85 mmHg has a causal role in premature heart injury in the young population due to the lack of repeated echocardiography measures.
The current study involved 1,856 adolescents of which 1,011 were women. The adolescents were 17 years old at baseline and were followed for 7 years until they were 24 years old. Elevated blood pressure and hypertension, as well as signs of heart damage were assessed at baseline and at follow-up.
Signs of heart structural damage are left ventricular hypertrophy and increased relative wall thickness, while signs of heart function damage are left ventricular diastolic dysfunction and increased left ventricular filling pressure.
During the 7-year follow-up period, the prevalence of high blood pressure, hypertension and heart damage in adolescents doubled. With extensive monitoring of fat mass, muscle mass, glucose, lipids, smoking status, sedentary time, physical activity, and family history of cardiovascular disease, and using adult cutpoints To diagnose heart damage, it has been observed that high blood pressure and hypertension caused premature heart damage in both males and females.
Importantly, there were specific features of high blood pressure and hypertension-related heart damage seen in each gender. For example, in men, high systolic blood pressure and hypertension were associated with an approximately 10-30% increased risk of heart function damage, but there was no risk of heart structural damage. .
However, in women, high systolic blood pressure and hypertension were associated with an approximately 60-217% increased risk of heart structural damage and a 35-65% increased risk of heart function damage. .
“This new evidence of the deleterious effect of high blood pressure and primary hypertension on the heart of the young population is alarming. The delay in initiating blood pressure screening in adolescence is unjustifiable given the extent of cardiac damage and potentially premature death that could be prevented. Therefore, public health experts, health policy makers, health journalists and bloggers, pediatricians and caregivers are encouraged to raise awareness in a meaningful way about the critical danger of high blood pressure and hypertension in young people. There should be push for legislative changes that mandate blood pressure screening in adolescents, as this could significantly reduce hypertension-related emergencies in adulthood,” says Andrew Agbaje, physician and clinical epidemiologist at the University of Eastern Finland.
Reference: “Raised Blood Pressure and Worsening Heart Damage During Adolescence” by Andrew O. Agbaje MD, MPH, March 3, 2023, The Journal of Pediatrics.
DOI: 10.1016/j.jpeds.2023.02.018
Dr. Agbaje’s research group (urFIT-child) is supported by research grants from the Jenny and Antti Wihuri Foundation, Finnish Cultural Foundation Central Fund, Finnish Cultural Foundation North Savo Regional Fund, Orion sr Research Foundation, Aarne Koskelo Foundation, from the Antti and Tyyne Soininen Foundation, the Paulo Foundation, the Yrjö Jahnsson Foundation, the Paavo Nurmi Foundation, the Finnish Foundation for Cardiovascular Research and the Foundation for Pediatric Research.