Researchers have found that elevated blood pressure and cholesterol levels in young adulthood may contribute to an increased risk of heart disease later in life, regardless of later in life exposure to these risk factors.
The research, published in theJournal of the American College of Cardiology, used data from 6 large, community-based, prospective cohort studies. The analysis included 36,030 participants and stretched over a median of 17 years. The authors defined “young” as between ages 18 and 39 years, and later adulthood as over age 40 years.
The researchers imputed risk factor trajectories for low-density lipoprotein and high-density lipoprotein cholesterols, systolic and diastolic blood pressure starting from age 18 years old for every participant. Time-weighted average exposures to each risk factor during young and later adulthood were calculated and linked to subsequent risks of coronary heart disease, heart failure, or stroke.
During the follow-up period, there were 4570 incidents of coronary heart disease, 5119 heart failure events, and 2862 stroke events.
Elevated LDL during young adulthood was associated with a 64% increased risk of coronary heart disease, regardless of later life exposures. High systolic blood pressure (SBP) and diastolic blood pressure (DBP) during young adulthood were independently associated with a 37% and 21% increased risk of heart failure, respectively. While high SBP or DBP during alter life were strong predictors of stroke events, no young adult exposures were independently associated with stroke risks.
The study did have limitations, however, namely its reliance on imputed risk factor levels before age 40 years. The authors recommended that future studies validate their findings in cohorts spanning young adulthood to later life.
Zhang Y, Vittinghoff E, Pletcher M, et al. Associations of Blood Pressure and Cholesterol Levels During Young Adulthood With Later Cardiovascular Events.Journal of the American College of Cardiology.2019;74(3).