CardioExchange Archive

CardioExchange, an NEJM practice community for medical professionals dedicated to improving cardiac patient care, was active from 2009 to 2015. CardioExchange fostered discussion between clinicians from across the globe.

January 26th, 2015

Isolated Systolic Hypertension in Younger Adults Linked to Increased CV Mortality

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 study in the Journal of the American College of Cardiology.

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. After multivariable adjustment, isolated systolic hypertension was associated with increased risks for CHD and CVD mortality, relative to normal-optimal blood pressure. For example, men with isolated systolic hypertension had a 28% increased risk for CHD mortality, while women had twice the risk.

Harlan Krumholz, editor-in-chief of CardioExchange, 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.”

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