Document Detail


Prehypertension during young adulthood and coronary calcium later in life.
MedLine Citation:
PMID:  18626048     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: High blood pressure in middle age is a well-established risk factor for cardiovascular disease, but the consequences of low-level elevations during young adulthood are unknown.
OBJECTIVE: To measure the association between prehypertension exposure before age 35 years and coronary calcium later in life.
DESIGN: Prospective cohort study.
SETTING: Four communities in the United States.
PARTICIPANTS: Black and white men and women age 18 to 30 years recruited for the CARDIA (Coronary Artery Risk Development in Young Adults) Study in 1985 through 1986 who were without hypertension before age 35 years.
MEASUREMENTS: Blood pressure trajectories for each participant were estimated by using measurements from 7 examinations over the course of 20 years. Cumulative exposure to blood pressure in the prehypertension range (systolic blood pressure of 120 to 139 mm Hg, or diastolic blood pressure of 80 to 89 mm Hg) from age 20 to 35 years was calculated in units of mm Hg-years (similar to pack-years of tobacco exposure) and related to the presence of coronary calcium measured at each participant's last examination (mean age, 44 years [SD, 4]).
RESULTS: Among 3560 participants, the 635 (18%) who developed prehypertension before age 35 years were more often black, male, overweight, and of lower socioeconomic status. Exposure to prehypertension before age 35 years, especially systolic prehypertension, showed a graded association with coronary calcium later in life (coronary calcium prevalence of 15%, 24%, and 38% for 0, 1 to 30, and >30 mm Hg-years of exposure, respectively; P < 0.001). This association remained strong after adjustment for blood pressure elevation after age 35 years and other coronary risk factors and participant characteristics.
LIMITATION: Coronary calcium, although a strong predictor of future coronary heart disease, is not a clinical outcome.
CONCLUSION: Prehypertension during young adulthood is common and is associated with coronary atherosclerosis 20 years later. Keeping systolic pressure below 120 mm Hg before age 35 years may provide important health benefits later in life.
Authors:
Mark J Pletcher; Kirsten Bibbins-Domingo; Cora E Lewis; Gina S Wei; Steve Sidney; J Jeffrey Carr; Eric Vittinghoff; Charles E McCulloch; Stephen B Hulley
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Annals of internal medicine     Volume:  149     ISSN:  1539-3704     ISO Abbreviation:  Ann. Intern. Med.     Publication Date:  2008 Jul 
Date Detail:
Created Date:  2008-07-15     Completed Date:  2008-07-22     Revised Date:  2011-09-26    
Medline Journal Info:
Nlm Unique ID:  0372351     Medline TA:  Ann Intern Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  91-9     Citation Subset:  AIM; IM    
Affiliation:
University of California, San Francisco, San Francisco General Hospital, San Francisco, California, USA. mpletcher@epi.ucsf.edu
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
African Continental Ancestry Group
Blood Pressure / physiology*
Calcinosis / ethnology,  physiopathology*,  radiography
Coronary Artery Disease / ethnology,  physiopathology*
European Continental Ancestry Group
Female
Humans
Longitudinal Studies
Male
Overweight
Risk Factors
Socioeconomic Factors
Tomography, X-Ray Computed / methods
Grant Support
ID/Acronym/Agency:
N01-HC-48047/HC/NHLBI NIH HHS; N01-HC-48048/HC/NHLBI NIH HHS; N01-HC-48049/HC/NHLBI NIH HHS; N01-HC-48050/HC/NHLBI NIH HHS; N01-HC-95095/HC/NHLBI NIH HHS; Z99 HL999999/HL/NHLBI NIH HHS
Comments/Corrections
Comment In:
Ann Intern Med. 2009 Jan 20;150(2):145   [PMID:  19153419 ]
Summary for patients in:
Ann Intern Med. 2008 Jul 15;149(2):I47   [PMID:  18626045 ]

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