Prehypertension during young adulthood associated with coronary calcium later in life
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The aim of this prospective cohort study was to establish the association between prehypertension exposure before age 35 years and coronary calcium, a surrogate of global atherosclerosis burden, including coronary atherosclerosis, in later life. A total of 3560 subjects recruited for the CARDIA study in 1985-1986, who were without hypertension before age 35, took part in this trial. Blood pressure trajectories for each participant were estimated by using measurements from 7 examinations over a 20-year period. Cumulative exposure to blood pressure in the prehypertension range from age 20 to 35 years was calculated in units of mm Hg-years of exposure. Exposure to prehypertension before age 35 years, especially systolic prehypertension, showed a significant graded association with coronary calcium later in life. This association remained robust even after adjusting for blood pressure elevation after age 35 years and for other coronary risk factors. Prehypertension during young adulthood is associated with coronary calcium score 20 years later. Keeping systolic pressure below 120 mm Hg before age 35 years may thus provide important health benefits, given that coronary calcium may predict hard cardiovascular clinical outcome.
Abstract
