Does Age of Hypertension Onset Affect Cardiovascular Outcomes?

Early diagnosis of hypertension is linked with greater chances of death from cardiovascular causes than hypertension that is diagnosed later in life. Early onset of hypertension is also likely to be heritable, researchers reported.

It is widely understood that hypertension at any age is associated with poor cardiovascular outcomes, but researchers wanted to know if the age of diagnosis has an impact on the degree of risk and potential for heritability.

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To investigate, the study’s authors evaluated data from the Framingham Heart Study, a multigenerational prospective cohort study. During a 60-year period, blood pressure measurements were recorded on 2 generations of community-dwelling participants. Mortality data were available on 3,614 first-generation participants. There were 1,635 second-generation participants who did not have hypertension and had data available on their parents’ blood pressure.

Results revealed that the odds of cardiovascular death rose in a linear fashion as the age of onset of hypertension decreased. Participants who had hypertension at less than age 45 years had an odds ratio of 2. 2(1.8 to 2.7) for cardiovascular death and 2.3 (1.8 to 2.9) for coronary death.

In contrast, those who were diagnosed with hypertension at age 65 years or older had a lower magnitude odds ratio of 1.5 (1.2 to 1.9) for cardiovascular death and 1.4 (0.98 to 1.9) for coronary death.

In addition, parents with early age of onset for hypertension were more likely to have children with hypertension, compared with parents who had late onset of hypertension.

“These findings suggest it may be important to distinguish between early onset and late onset hypertension as a familial trait when assessing an individual’s risk for hypertension, and as a specific type of blood pressure trait when estimating risk for cardiovascular outcomes in adults with established hypertension,” the researchers concluded.

—Lauren LeBano

Reference

Niiranen TJ, McCabe EL, Larson MG, et al. Heritability and risks associated with early onset hypertension: multigenerational, prospective analysis in the Framingham Heart Study. BMJ. May 2017;357. doi: https://doi.org/10.1136/bmj.j1949.