Consistency of blood pressure and impact on cardiovascular structure over 20 years in young men

• Published in: Journal of Internal Medicine
• Main Authors: Ridderstråle, W., Saluveer, O., Johansson, M. C., Bergbrant, A., Jern, S., Hrafnkelsdóttir, T. J.
• Format: Article in Journal/Newspaper
• Language: English
• Published: Wiley 2010
• Subjects: Reykjavík; Iceland
• Online Access: http://dx.doi.org/10.1111/j.1365-2796.2009.02142.x; https://api.wiley.com/onlinelibrary/tdm/v1/articles/10.1111%2Fj.1365-2796.2009.02142.x; https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1365-2796.2009.02142.x

Abstract. Ridderstråle W, Saluveer O, Johansson MC, Bergbrant A, Jern S, Hrafnkelsdóttir TJ (Sahlgrenska University Hospital Östra, Gothenburg; AstraZeneca, Mölndal, Sweden, Landspítali University Hospital, Reykjavík, Iceland). Consistency of blood pressure and impact on cardiovascular structure over 20 years in young men. J Intern Med 2010; 267 : 295–304. Objective. To identify, in a prospective study, how blood pressure levels at the age of twenty predict hypertension and cardiovascular remodelling 20 years later. Methods. Twenty‐year‐old men with blood pressure (BP) elevation [systolic blood pressure (SBP) 140–160 and/or diastolic blood pressure (DBP) 85–95 mmHg; blood pressure elevation (BPE) group] or normal BP [SBP 110–130 and DBP 60–80 mmHg; normal controls (NC) group] entered the study in 1987. In 2007, follow‐up was conducted including ambulatory BP, echocardiography, anthropometric and intima media thickness (IMT) measurements. Results. Assessed with 24‐h ambulatory BP, the prevalence of hypertension was 35/47 (74.5%) and 1/17 (5.9%) in the BPE and NC group at follow‐up respectively. Twenty‐four hour mean arterial pressure (MAP) increased from 86.6 (0.8) to 97.2 (1.2) ( P < 0.0001), and from 83.1 (1.5) to 88.1 (1.2) mmHg ( P < 0.01) from baseline to follow‐up in the BPE and NC group respectively. At follow‐up, left ventricular mass index (LVMI) was 122 (4) and 106 (4) g m −1 in the BPE and NC group (unpaired t‐ test; P < 0.01) respectively, whilst IMT was 0.61 (0.01) and 0.57 (0.01) mm in the BPE and NC group ( P < 0.05) respectively. In a logistic regression model, prevalence of hypertension was best explained by office MAP and 24‐h DBP at baseline ( R 2 0.333; P < 0.05). A combined model of office MAP, body mass index and insulin levels at baseline explained 56% of LVMI at follow‐up. Conclusions. BP elevation in young age predicts hypertension and adverse cardiovascular remodelling at the age of 40 years. Baseline office MAP is the best predictor of hypertension, 24‐h MAP and LVMI.