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Teens Risk Cardiac, Vascular Damage at BPs below Hypertension

Written by Urbina EM
Monday, 15 January 2018

Target organ damage to the heart and blood vessels can occur in teenagers at blood-pressure levels below the clinical definition of pediatric hypertension [1].

This means we really need to start early on good lifestyle changes, including healthy diet and exercise, to maintain good levels of blood pressure and body proportions so we can prevent hypertension and the consequences such as heart attack and stroke. The study was presented at the 2017 American Heart Association (AHA) Council on Hypertension, AHA Council on Kidney in Cardiovascular Disease, American Society of Hypertension Joint Scientific Sessions.

In childhood, high blood pressure is based on percentiles, rather than blood-pressure level. Urbina and colleagues set out to determine whether organ damage in teenagers develops below the 95th percentile—the clinical definition of pediatric hypertension. They measured blood pressure, left ventricular mass (LVM), and arterial stiffness (pulse-wave velocity [PWV]) in 180 teenagers 14 to 17 years old (64% white, 57% male).

Based on an average of six systolic blood-pressure (SBP) readings, participants were classified as normal or low-risk (SBP <80th percentile, n=104), mid-risk (SBP 80th to 90th percentile, n=38), or high-risk (SBP >90th percentile, n=38), according to age, sex, and height-specific pediatric cut points. The groups did not differ by age, sex, race, or BMI. Mean blood pressure increased across the three risk groups, from 109/74 mm Hg in the low-risk group to 126/82 mm Hg in the mid-risk group and 135/87 mm Hg in the high-risk group (P<0.0001). LVM and PWV also increased across groups (LVM 31.5, 34.7, and 35.3 g/m2.7, respectively; and PWV 4.8, 5.2, and 5.3 m/sec, respectively).

There was evidence of organ damage in all three risk groups, the researchers say, and SBP percentile remained a significant determinant of target organ damage after adjustment for relevant cofactors, including demographics, age, and BMI.

References

Urbina EM, et al. Target organ damage occurs at SBP levels below the 95th percentile in adolescents: The SHIP AHOY Study. 2017 H Council on Hypertension, AHA Council on Kidney in CVD, American Society of Hypertension Joint Scientific Sessions. September 17, 2017; San Francisco, CA. Abstract 17-HBPR-A-376-AHA.