A recent study from Linköping University in Sweden has revealed that even a seemingly normal blood pressure reading of 120/80 mm Hg during adolescence can significantly increase the risk of developing atherosclerosis in middle age. The findings, published in the journal JAMA Cardiology, underscore the critical role that early-life blood pressure plays in the development of coronary artery disease.
“High blood pressure is the largest modifiable risk factor for cardiovascular disease, which in turn is the largest single cause of death globally,” stated Pontus Henriksson, senior associate professor of nutritional physiology at Linköping University. Henriksson led the study alongside Karin Rådholm, senior associate professor of general medicine.
Early Intervention and Prevention
The current approach to preventing and treating high blood pressure, or hypertension, primarily targets adults. However, the Swedish study supports the notion that blood pressure impacts health from a much younger age. The researchers utilized advanced CT coronary artery scans to assess the coronary arteries of approximately 15,000 men aged 50 to 64 years, as part of the national SCAPIS study. These scans provided high-resolution images of atherosclerosis plaques, which are crucial in evaluating cardiovascular risk.
Remarkably, over 10,200 of these men had undergone mandatory military conscription tests at age 18, providing a representative dataset of Swedish men from that era. The study examined the correlation between their adolescent blood pressure and the condition of their coronary arteries nearly four decades later.
The Mechanics of Blood Pressure
Blood pressure refers to the force exerted by circulating blood on the walls of blood vessels. It is measured in millimeters of mercury (mm Hg) and consists of two numbers: systolic pressure (when the heart pumps blood) and diastolic pressure (when the heart rests between beats). According to Swedish guidelines, a blood pressure below 140/90 mm Hg is considered normal.
“The most important thing we see is that those who had a systolic pressure of 140 or a diastolic pressure of 90 or more were at a clearly increased risk of coronary artery atherosclerosis later in life. But the risk increased already at 120/80 mm Hg,” said Karin Rådholm, who is also a General Practitioner at Vårdcentralen Kärna in Region Östergötland.
Changing Guidelines and Implications
Recent international recommendations have lowered the threshold for elevated blood pressure to 120/80 mm Hg, suggesting that more individuals are now considered at risk. The study found a direct relationship between higher blood pressure at the time of military conscription and increased risk of atherosclerosis in middle age, even at the lower threshold of 120/80 mm Hg. The researchers accounted for various factors affecting cardiovascular disease risk in their analyses.
“The study shows that the development of atherosclerosis begins early. The health care system needs to treat high blood pressure in young people more actively. The problem is that high blood pressure rarely causes symptoms. It’s not something you can feel, so if you don’t measure your blood pressure, you can have hypertension without knowing it,” emphasized Rådholm.
Modern Lifestyle and Health Risks
Factors contributing to high blood pressure, such as obesity and poor physical fitness, are more prevalent among today’s youth compared to the study participants 40 years ago. Henriksson noted, “In just one to two generations, the proportion of young people with obesity has increased significantly while fitness has decreased. So, these results are highly relevant for those who are young today.”
It is important to note that the study only included men, limiting the ability to draw conclusions about women’s risk for similar conditions. The research received funding from several organizations, including the Heart-Lung Foundation, the Knut and Alice Wallenberg Foundation, the Swedish Research Council, Vinnova, and the Joanna Cocozza Foundation for Children’s Medical Research.
Looking Forward
The implications of this study suggest a need for a paradigm shift in how healthcare systems approach blood pressure management, emphasizing early intervention. As the prevalence of lifestyle-related risk factors continues to rise among younger populations, proactive measures in monitoring and managing blood pressure from adolescence could be crucial in reducing future cardiovascular disease burdens.
As the medical community digests these findings, further research may be warranted to explore similar patterns in women and other demographics. The study serves as a reminder of the silent yet significant impact of hypertension, urging a reevaluation of preventive health strategies.
