Arterial hypertension, high cholesterol at the beginning of life linked to heart problems later


(Reuters Health) – People with high blood pressure or high cholesterol before the age of 40 are more likely to have a heart attack later in life than other adults, a new analysis suggests.

The analysis has grouped the data of six studies for a total of 36,030 people. Since the participants were on average 53 years old, the researchers tracked them down to see who had heart attacks, strokes or heart failure.

At a time when half of the people had been monitored for at least 17 years, participants who had elevated levels of "bad" LDL cholesterol before age 40, or more than 129 milligrams per deciliter of blood, had a 64% chance of more than they had events like heart attacks compared to people with low LDL levels in early adulthood.

The upper limit of normal blood pressure is 120/80. The young adults with a high systolic pressure – the "highest number" – were 37% more likely to develop heart failure later in life. And young adults who had elevated diastolic blood pressure – the "lower number" – were 21% more likely to develop heart failure later.

"Many young adults feel good, or are willing to think – now I'm fine, I will make healthy choices later when I'm older," said Dr. Andrew Moran, senior author of the study and researcher at Columbia University Medical Center in New York City.

"This study shows that healthy choices are also important for young adults," Moran said via e-mail. "This means not smoking, following a healthy diet and exercising regularly."

And for some high-risk young adults, administering drugs to manage risk factors at a younger age – which is not currently done naturally – can be helpful, Moran added.

Very few people in the study had high blood pressure or high cholesterol during young adulthood, the researchers report in the Journal of the American College of Cardiology.

During follow-up, 4,570 participants had events such as heart attacks, 5,119 had heart failure events and 2,862 had strokes.

The study cannot explain whether or how high blood pressure or high cholesterol in early adulthood can directly cause heart attacks, strokes or heart failure at later ages.

One limitation of the analysis is that, since the smaller studies used in the analysis had no measurements of blood pressure and cholesterol over the course of life, in some cases the researchers had to estimate how many younger people had these risk factors based on the data they had for older participants.

"Heart failure and heart attacks are the result of years of exposure to risk factors such as hypertension and cholesterol," said Dr. Samuel Gidding, co-author of an editorial accompanying the study and medical director of the FH (Familial Hypercholesterolemia) Foundation in Pasadena, California.

"Both cause the accumulation of fat in the coronary arteries starting from childhood; this leads to a heart attack later in life," Gidding said via e-mail. "Hypertension puts a strain on the heart and adapts to that stress leads to heart failure."

SOURCE: is Journal of American College of Cardiology, online 15 July 2019.


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