Isolated Systolic Hypertension in Younger Adults Linked to Increased CV Mortality

By Amy Orciari Herman

Edited by David G. Fairchild, MD, MPH, and Jaye Elizabeth Hefner, MD

Young and middle-aged adults with isolated systolic hypertension face increased long-term risks for coronary heart disease (CHD) and cardiovascular disease (CVD) mortality, according to a Journal of the American College of Cardiology study.

Researchers studied some 27,000 adults in the Chicago area who were under age 50 and had their blood pressure measured at baseline (those who had pre-existing CHD or were taking antihypertensives were excluded). Roughly 25% of men and 13% of women had isolated systolic hypertension (systolic BP 140 mm Hg or higher, diastolic BP below 90).

During 31 years' follow-up, some 1700 deaths from cardiovascular disease, 1200 from CHD, and 200 from stroke occurred. Men with isolated systolic hypertension had a 28% increased risk for CHD mortality — and women had twice the risk — relative to those with optimal–normal blood pressure. Findings were similar for CVD mortality.

Harlan Krumholz, editor-in-chief of NEJM Journal Watch Cardiology, commented: "This study reaffirms years of work that higher systolic blood pressure is a marker of higher risk. Behavior interventions seem reasonable for this group, but whether lifelong antihypertensive therapy [is indicated] for mild elevations in systolic hypertension remains an open question that cannot be answered by this study."