Abstract 14701: Future Risk of Cardiovascular Disease in Adults with Prolonged Exposure to High Blood Pressure
Introduction: High blood pressure (HBP) in early and mid-adulthood has been associated with increased future risk of cardiovascular disease (CVD).
Hypothesis: In addition to prevalent disease, the cumulative duration of exposure to HBP by mid-adulthood is independently associated with future CVD risk.
Methods: Using 1478 adults from the Framingham Offspring Cohort who were free of CVD at age 55 (n=1514), the association between the duration of HBP (SBP ≥140 or DBP ≥90) prior to age 55 and subsequent CVD over the next 20 years was evaluated.
Results: The rate of CVD increased linearly with increasing duration of elevated BP. At median follow-up (15 years), CVD occurred in 11.1% (95% CI: 9.1-13.7%) of adults without elevated BP, 19.8% (95% CI: 18.1-24.4%) of adults with 1-10 years of HBP at age 55, and 30.2% (95% CI: 23.8-37.8%) of adults with 11-20 years of HBP exposure at age 55. The association between duration of HBP and CVD remained significant after adjusting for other risk factors at age 55 (smoking, sex, age, diabetes, cholesterol, SBP, and DBP) and BP therapy at age 55 and at follow-up. In adjusted analysis, every decade of exposure to HBP by age 55 was associated with a 29% increase in future CVD risk (HR 1.29, 95% CI 1.01-1.65 p=0.04).
Conclusions: The duration of exposure to elevated BP by age 55 was independently associated with future CVD risk in a dose-responsive pattern even after adjusting for baseline BP and other prevalent risk factors. This supports continued efforts to treat hypertension in young adults as part of a comprehensive strategy for primary prevention of CVD.
Author Disclosures: A.M. Navar-Boggan: None. E.D. Peterson: Research Grant; Modest; Eli Lilly, Janssen. Consultant/Advisory Board; Modest; Sanofi-Aventis, Janssen, Genentech, Boehringer Ingelheim. R.B. D’Agostino: None. B. Neely: None. A.D. Sniderman: None. M.J. Pencina: Consultant/Advisory Board; Modest; AbbVie.
- © 2014 by American Heart Association, Inc.