MedicalResearch.com Interview with:
Seulggie Choi MD, (one of the co-first authors)
Department of Biomedical Sciences
Seoul National University Graduate School
Seoul, South Korea
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: In 2017, the American College of Cardiology (ACC) and American Heart Association (AHA) issued a new High Blood Pressure Management Guideline, in which the definition of hypertension was modified as blood pressure of 130/80 mmHg or higher. This new criteria for hypertension was based on a number of previous studies that demonstrated higher cardiovascular disease risk for participants in the systolic blood pressure of 130-139 mmHg and diastolic blood pressure of 80-89 mmHg range, which is now defined as stage 1 hypertension. However, there is a relative lack of evidence on whether this association of higher cardiovascular disease risk among those within the stage 1 hypertension category according to the 2017 ACC/AHA guidelines is also true among young adults aged 20-39 years.
Our study consisted of about 2.4 million young men and women aged 20-39 years from the Korean National Health Insurance Service claims database. Compared to those with normal blood pressure, young adults with stage 1 hypertension had higher risk for cardiovascular disease, coronary heart disease, and total stroke for both men and women. Moreover, among those who were prescribed anti-hypertensive medications within the next 5 years since blood pressure measurement, young adults with stage 1 hypertension had their higher cardiovascular disease risk attenuated to that of normal blood pressure participants.
MedicalResearch.com: What should readers take away from your report?
Response: Hypertension according to the new 2017 ACC/AHA guidelines was associated with higher cardiovascular disease risk even among young adults. Our findings provide further support for the new stricter hypertension criteria and suggest that hypertension at a relatively young age of 20-39 years may elevate the risk for cardiovascular disease. Furthermore, early hypertension management in those age group may be associated with reduced risk of cardiovascular disease. However, our findings may be confounded by a number of factors such as differences in access to care and require validation in future prospective studies.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: We have demonstrated that stage 1 hypertension was associated with higher risk for cardiovascular disease risk among young adults. Therefore, the next question would be whether improvements in blood pressure levels actually lead to reduced cardiovascular disease risk. While we attempted to answer this question by considering anti-hypertensive medication prescriptions, future prospective studies are needed to further explore whether hypertension management is beneficial for cardiovascular disease risk among this relatively young age group.
MedicalResearch.com: Is there anything else you would like to add?
Response: Our team, the Health System Data Science Lab, is interested in answering questions of public health and clinical significance using a wide range of large-scale databases. We attempt to answer these questions using a number of methods spanning from pharmaco-epidemiology to cost-effective analysis. We hope to shed light into important clinical questions that were previously unanswered using data science. In this process, we firmly believe that collaborations with experts from different fields are incredibly valuable in enhancing the quality of our studies and are always open to new collaborations. We have nothing to disclose.
Son JS, Choi S, Kim K, et al. Association of Blood Pressure Classification in Korean Young Adults According to the 2017 American College of Cardiology/American Heart Association Guidelines With Subsequent Cardiovascular Disease Events. JAMA. 2018;320(17):1783–1792. doi:10.1001/jama.2018.16501
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