Elevated Blood Pressure in Young Adult Men Linked to Future Heart Disease (March 28, 2008) By Donald J. Brown, ND

Young adult men with above-normal blood pressure are at greater risk of dying from future cardiovascular disease than those with normal blood pressure, according to a study published in this week?s Archives of Internal Medicine.

As part of the Chicago Heart Association Detection Project in Industry study, 10,874 men aged 18 to 39 years (average age of 30 years) with no known history of heart disease, diabetes, or taking blood pressure medications had their blood pressure measured by medical personnel. Twenty-five years later, researchers followed up with each participant to determine his cardiovascular health and to determine cause of death in those who were deceased.

In the study, men with high-normal blood pressure and mild (also called stage 1) hypertension were more likely to die of coronary heart disease or cardiovascular disease than those with either normal or optimal blood pressure. Those with high-normal blood pressure had a life expectancy shortened by 2.2 years compared with those who had normal or optimal blood pressure, while the life spans of those with mild hypertension were shortened by an average of 4.1 years.

Perhaps most startling is the finding that only 28.8% of the young men had either normal or optimal blood pressure at the beginning of the study. Even at a young age, the majority of the men studied (71.2%) had elevated blood pressure: 25.5% had high-normal blood pressure, 36.4% had mild hypertension, 7.8% had moderate hypertension and 1.5% had severe hypertension. The authors of the study attribute this to the ?adverse impact of dietary and other lifestyle traits leading to blood pressure rise from youth onward in most people.

Prevention Starts Early

Hailed as the first study to clearly show a link between blood pressure elevations in young adulthood and later risk of death due to cardiovascular disease, the study reinforces the need for dietary and lifestyle education aimed at reducing risk of high blood pressure in the general population. It also points to the importance of screening for blood pressure elevations in children, adolescents, and young adults.

The authors of the study emphasized the primary importance of prevention through a healthful lifestyle and diet. In addition to exercise and weight management, a healthful diet is likely to increase chances of blood pressure remaining normal in young adulthood and thus decreasing risk of heart or other cardiovascular disease in middle-age or later adulthood. Key among prevention strategies cited are basic nutritional guidelines such as reducing salt, sugar, saturated fats, and alcohol intake while increasing intake of fruits, vegetables, whole grains, legumes, and low-fat protein sources such as fish.

Clinical studies have consistently shown that dietary changes can effectively prevent, and even reduce, high blood pressure. In the Dietary Approaches to Stop Hypertension (DASH) trial, increasing intake of fruits and vegetables (and therefore fiber) and reducing cholesterol and dairy fat led to large reductions in blood pressure in just eight weeks.2 Adding salt restriction to the DASH diet has led to even greater reductions in blood pressure.

The results of the new study emphasize the importance of regular monitoring of blood pressure even in young adulthood. Keeping blood pressure within normal limits during young adulthood appears to paint a rosier picture of cardiovascular health in later life.

Source:

1. Miura K, Daviglus ML, Dyer AR, et al. Relationship of blood pressure to 25-year mortality due to coronary heart disease, cardiovascular disease, and all causes in young adult men. Arch Intern Med 2001;161:1501?8.
2. Appel LJ, Moore TJ, Boarzanek E, et al. A clinical trial of the effects of dietary patterns on blood pressure. N Engl J Med 1997;336:1117?24.
3. Sachs FM, Svetkey LP, Vollmer WM, et al. Effects on blood pressure of reduced dietary sodium and the dietary approaches to stop hypertension (DASH) diet. N Engl J Med 2001;344:3?10.

Donald J. Brown, ND, is a naturopathic physician and one of the leading authorities in the United States on evidence-based herbal medicine. He is the founder and director of Natural Products Research Consultants, Inc., and serves on the Advisory Board of the American Botanical Council and the President's Advisory Board of Bastyr University.