Tracking high blood pressure may help predict atherosclerosis risk, JAMA study shows

Individuals who experience consistent increases in blood pressure starting around their 20s are more likely to develop atherosclerosis by the time they reach middle-age, according to a new study that followed 4,681 patients for 25 years. Monitoring long-term patterns of changes in blood pressure may help physicians more accurately identify a patient's risk of developing heart disease, the authors said.

Though high blood pressure is a well-known predictor of heart disease risk, most models take into account blood pressure at only a single point in time, usually when the patient is already middle-aged or older. The study published Tuesday in the Journal of the American Medical Association, followed patients from young adulthood to middle-age, taking note of differences in blood pressure over time in trajectories ranging from low and stable, to elevated and increasing. This is “a novel approach” to assessing coronary heart disease, an accompanying editorial said.

“The data offer an important perspective to support a preventive approach to reduce coronary heart disease risk by demonstrating the existence of widely different BP trajectories ranging from young adulthood through middle age,” the editorial said. “Further research is warranted to explore the associations of BP trajectories with development of advancing chronic kidney disease and heart failure and to provide novel tools for risk prediction to guide interventions for BP lowering in everyday practice.”

The findings also offer insight into health disparities. Individuals with blood pressure in the low-stable trajectory were more likely to be female, white and more highly educated, while those with blood pressure in the “increasing” trajectories—meaning they experienced rapid increases in blood-pressure levels, starting at an average age of 35—were more likely to be African-American. They also were more likely to be smokers and have elevated BMI levels.

About 1 in 3 adults in the U.S. has high blood pressure, meaning their levels remain at or above 140/90 mmHg. The condition often has no signs or symptoms, and patient may go undiagnosed for years while high blood pressure leads to damage in the heart, blood vessels, kidneys and other parts of the body, according to the NIH. High blood pressure is a major risk factor for the development of atherosclerosis, a build-up of plaque inside the arteries, which can eventually lead to a heart attack.

Follow Sabriya Rice on Twitter: @MHSRice