Younger adults, especially men, less likely to treat high blood pressure

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[August 29, 2017] By Lisa Rapaport

(Reuters Health) - Younger adults are less likely than older people to know they have high blood pressure and to treat the condition, increasing their risk for heart attacks and strokes, a U.S. study suggests.

For the study, researchers examined data from more than 41,000 participants in eight national health surveys from 1999 to 2014.

Their findings, extended to the general population, suggest that by the end of the study period, only half of the 6.7 million young adults aged 18 to 39 with high blood pressure received treatment and only 40 percent got their blood pressure, or hypertension, under control.

By comparison, 70 percent of middle-aged adults aged 40 to 59 and 83 percent of adults aged 60 and older with high blood pressure got it treated, and more than half of these older patients got the condition under control.

“Hypertension awareness, treatment, and control have improved in young adults in recent years, but not enough to close the quality gap in hypertension management between young and older adults,” said study co-author Dr. Andrew Moran of Columbia University Medical Center in New York City.

Overall, about 75 million U.S. adults, or 32 percent, had high blood pressure by the end of the study period, researchers report in the journal Hypertension.

Men account for much of the age gap in blood pressure treatment and control, the study found.

For example, 68 percent of young men with high blood pressure knew they had the condition, compared with 86 percent of young women.

Just 44 percent of young men with high blood pressure received treatment for the condition, and only 34 percent got their blood pressure under control.

More than 61 percent of young women with high blood pressure got treatment and 52 percent of them got the condition under control, the study found.

While the study didn’t examine why young women did better at managing high blood pressure than young men, the study authors say it’s possible women get more frequent blood pressure checks because they have more routine healthcare visits for gynecological exams or prenatal care.

Obesity also contributed to age differences in high blood pressure.

Almost three in four young adults with high blood pressure were obese, compared with 57 percent of middle-aged adults and 42 percent of older adults.

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The study included survey data on 41,331 adults.

It wasn’t a controlled experiment designed to prove whether or how factors like age, obesity or gender might influence the odds of developing high blood pressure or treating it properly.

Another limitation is that researchers only had blood pressure data from a single point in time, and they lacked data on lifestyle modifications to manage hypertension such as changes in diet or exercise habits.

Even so, elevated blood pressure in adolescence and young adulthood can contribute to changes in blood vessels that lead to heart attacks and strokes later in life, said Dr. Holly Gooding, a researcher at Harvard Medical School and Brigham and Women’s Hospital in Boston who wasn’t involved in the study.

“The best strategy is to prevent high blood pressure in the first place, by engaging in regular physical activity, eating a heart healthy diet, and avoiding tobacco,” Gooding said by email.

When people do need medication to manage high blood pressure, they can get better results when they’re young, Gooding noted.

“This is yet another reason to focus greater resources on cardiovascular disease prevention earlier in life,” Gooding said. “We are likely to get more return on our investment.”

SOURCE: Hypertension, online August 28, 2017.

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