Increasing BP level in late adolescence ups risk of cardiovascular events

Rising levels of blood pressure (BP), starting at 120/80 mm Hg, during late adolescence contribute to a gradual elevation in the risk of major cardiovascular events, reports a study in Sweden.

A total of 1,366,519 males in late adolescence (mean age 18.3 years) who were conscripted into the military from 1969 to 1997 were assessed in this cohort study. Baseline BP measurement was carried out at conscription. The primary outcome was a composite of cardiovascular death or first hospitalization for myocardial infarction, heart failure, ischaemic stroke, or intracerebral haemorrhage.

At baseline, 28.8 percent of participants had elevated BP (120 to 129/<80 mm Hg) while more than half (53.7 percent) were hypertensive (≥130/80 mm Hg). A total of 79,644 men had a primary outcome during a median follow-up of 35.9 years.

Adjusted hazard ratios were 1.10 (95 percent confidence interval [CI], 1.07‒1.13) for elevated BP, 1.15 (95 percent CI, 1.11‒1.18) for stage 1 isolated systolic hypertension (ISH), 1.23 (95 percent CI, 1.18‒1.28) for stage 1 isolated diastolic hypertension (IDH), 1.32 (95 percent CI, 1.27‒1.37) for stage 1 systolic‒diastolic hypertension (SDH), 1.31 (95 percent CI, 1.28‒1.35) for stage 2 ISH, 1.55 (95 percent CI, 1.42‒1.69) for stage 2 IDH, and 1.71 (95 percent CI, 1.58‒1.84) for stage 2 SDH.

At age 68 years, a gradual increase was noted in the cumulative risk for cardiovascular events across BP stages, which ranged from 14.7 percent for normal BP to 24.3 percent for stage 2 SDH.