Lifestyle changes are key to improving health of young people with specific form of high BP
Breakthrough study determines age is the most important consideration in the clinical treatment of one in ten adults with condition.
A global study by NUI Galway into health risks associated with a specific form of high BP has found that younger patients with the condition are more at risk of a cardiovascular event or death.
The research found that over 50s with high diastolic blood pressure and normal systolic blood pressure – a high value on the bottom reading – are not at increased risk of cardiovascular disease.
However, the condition increases the risk for cardiovascular events, or death, for younger people.
High diastolic blood pressure is known as isolated diastolic hypertension (IDH). The American Heart Association defined it as a diastolic blood pressure greater than 80mmHg and systolic blood pressure less than 130 mmHg.
Hypertension, a journal of the American Heart Association published the findings.
The research was led by Professor William McEvoy, Professor of Preventive Cardiology at NUI Galway. He is a consultant cardiologist at Galway University Hospitals. This is in addition to Medical Director of the National Institute for Prevention and Cardiovascular Health (NIPC).
Prof J Staessen at the University of Leuven, Belgium led a team of investigators in collaboration.
The study examined data from 11,135 patients worldwide. All of them underwent a 24-hour BP assessment, known as ambulatory blood pressure monitoring (ABPM). It is considered to be far more accurate than office-based BP when managing cardiovascular disease risk.
Professor McEvoy explained the findings. He said, “While IDH is less common than other forms of blood pressure, it can be seen in 6-11% of the adult population. It is more common in younger adults.
“What we found only patients with IDH younger than 50 are at greater risk of heart-attack or cardiovascular events.”
Professor McEvoy said: “Previous research in this area left some unanswered questions. Our recommendation to physicians on the back of this research is patients under 50 with IDH need to tackle unhealthy lifestyle and diet.
“They also need more close monitoring of their systolic blood pressure – the top value on the blood pressure reading. This is because they are more likely to develop high systolic blood pressure values that may require drug treatment.”
What should young people with high diastolic blood pressure do?
Professor McEvoy said the findings don’t lead to clear recommendation for young adults with IDH to be treated with BP lowering medications.
“While they’re at increased risk of cardiovascular events, the actual likelihood of an event is still low in young people.
“Prevention of cardiovascular events is possible. Our recommendations for patients under 50 who have been diagnosed with IDH is to make healthy changes to their lifestyle. Also defer drug treatment, while ensuring they have annual BP checks with their doctor, unless elevated systolic blood pressure develops.
“For over 50s with IDH, there does not seem to be an indication to provide drug treatment. This is as long as the diastolic blood pressure is between 80 to 90 mmHg.”
The Executive Dean of the College of Medicine, Nursing and Health Science at NUI Galway, Consultant at Saolta University Hospitals Group spoke about the research. Professor Tim O’Brien said: “I welcome this breakthrough research. It helps to settle an open question, raised by previous research and using less rigorous recording of BP.
“Prevention is critical when it comes to the management of patients with cardiovascular disease. This research will help clinical teams make better informed decisions about the management of patient health when treating IDH.”
You can view the full paper HERE
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