Two DCRI researchers contributed to a study that points to a potential early warning sign for increased risk of cardiovascular disease.
A new study conducted by Duke and DCRI researchers reveals that young adults who have variable blood pressure readings may be at higher risk of cardiovascular disease by middle age.
Study results were published today in JAMA Cardiology. Lead author and Duke faculty member Yuichiro Yano, MD, PhD, said the findings suggest that current practice, which averages fluctuating blood pressure readings to determine whether medications are necessary, could be overlooking a potential early warning sign.
“If a patient comes in with one reading in December and a significantly lower reading in January, the average might be within the range that would appear normal,” Yano said in a news release issued by Duke Health News. “But is that difference associated with health outcomes in later life? That’s the question we sought to answer in this study, and it turns out the answer is yes.”
Yano and colleagues, including the DCRI’s Ann Marie Navar, MD, PhD, and Eric Peterson, MD, MPH, analyzed 30 years of data from a large, diverse cohort of 3,394 young people enrolled in the Coronary Artery Risk Development in Young Adults study between March 1985 and June 1986.
The main reading the study examined was the systolic blood pressure level, the upper number in the equation that measures the pressure in the blood vessels when the heart pumps. A systolic blood pressure reading over 130 is considered hypertensive and has long been a major risk factor for cardiovascular disease. The study team was able to identify which young people had variations in systolic blood pressure by the age of 35 and then follow them for 20 years to determine whether there appeared to be a correlating increase in cardiovascular disease.
The researchers found that each 3.6-mm spike in systolic blood pressure during young adulthood was associated with a 15 percent higher risk for heart disease events, independent of the averaged blood pressure levels during young adulthood and any single systolic blood pressure measurement in midlife.
“Studies like this one indicate that we still have a lot to learn about the world’s most common and modifiable cardiac risk factor, blood pressure,” Peterson said. “These data show that continuously monitoring blood pressure and looking for spikes and variations can add important prognostic information and potentially affect treatment decisions.”
In addition to Yano, Navar, and Peterson, study authors included Jared Reis, Cora Lewis, Stephen Sidney, Mark Pletcher, Kirsten Bibbins-Domingo, Michael Bancks, Hiroshi Kanegae, Samuel Gidding, Paul Muntner and Donald Lloyd-Jones.
The study received funding support from the National Heart, Lung, and Blood Institute (HHSN268201800005I, HHSN268201800007I, HHSN268201800003I, HHSN268201800006I, HHSN268201800004I, R01 HL144773-01, T32HL069771, K01HL133416).