Blood pressure hike in middle age predicts heart attack or stroke

by Bruce Sylvester – Men and women who develop high blood pressure during middle age or who enter middle age with high blood pressure have about a 30% increased lifetime risk of heart attack or stroke compared to those who kept their blood pressure low. Researchers reported this finding on Dec. 19, 2011 in Circulation.

The investigators retrospectively evaluated data from 61,585 participants in the Cardiovascular Lifetime Risk Pooling Project. They studied blood pressure readings taken at age 41 and 55, and then they tracked the subjects for first heart attack, stroke, death or age 95.

Men who developed high blood pressure in middle age or who began the study with high blood pressure showed a 70% lifetime risk of having a heart attack or stroke, compared to a 41% risk for men with low blood pressure or whose blood pressure decreased during the study. Women who developed high blood pressure in middle age showed about a 50% risk of a heart attack or stroke compared to a 22% risk for subjects who had blood pressure low or achieved a decrease during the study.

The authors noted that men generally have a 55% lifetime risk of cardiovascular disease, and women have a 40% risk.

Previously, risk estimates for cardiovascular disease were based on a single blood pressure measurement. The new study suggests that a more accurate predictor is a change in blood pressure from age 41 to 55.

“We found the longer we can prevent hypertension or postpone it, the lower the risk for cardiovascular disease,” said lead author Norrina Allen, Ph.D,  assistant professor of preventive medicine at Northwestern University Feinberg School of Medicine in Chicago. “Even for people with normal blood pressure, we want to make sure they keep it at that level, and it doesn’t start increasing over time.”

“There hasn’t been as much of a focus on keeping it low when people are in their 40s and 50’s,” Allen added. “That’s before a lot of people start focusing on cardiovascular disease risk factors. We’ve shown it’s vital to start early.”

“Our research suggests people can take preventive steps to keep their blood pressure low early on to reduce their chances of a heart attack or stroke,” said Donald M. Lloyd-Jones, MD, study co-author, chair of preventive medicine at Northwestern’s Feinberg School and a cardiologist at Northwestern Memorial Hospital. “Maintaining a healthy diet, combined with exercise and weight control, can help reduce blood pressure levels and, consequently, your risk for cardiovascular disease later in life.”