Dr. Yano[/caption]
Yuichiro Yano MD PhD
Assistant Professor in Community and Family Medicine
Duke University
MedicalResearch.com: What is the background for this study?
Response: New blood pressure guidelines, issued in 2017 in the US, lowered the blood pressure thresholds for hypertension from systolic blood pressure/diastolic ≥140/90 mm Hg to systolic/diastolic ≥130/80 mm Hg. This change increased the prevalence of hypertension two- to three-fold among young adults. The guidelines also newly defined elevated blood pressure as, 120-129 mmHg systolic blood pressure over 80 mmHg diastolic or less. However, no study investigated that high blood pressure, as defined by the new criteria, is something that younger people should be concerned about as a potential precursor to serious problems.
Our study is among the first to report that people younger than age 40 who have elevated blood pressure or hypertension are at increased risk of heart failure, strokes and blood vessel blockages as they age.
Dr. Rahimi[/caption]
Professor Kazem Rahimi, FRCP MD DM MSc FES
Deputy Director, The George Institute for Global Health UK
Associate Professor of Cardiovascular Medicine, University of Oxford
Honorary Consultant Cardiologist, Oxford University Hospitals NHS Trust
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Mitral regurgitation, the most common heart valve disorder in high-income countries, has until now been considered a degenerative disorder, which results from damage over time due to ‘wear and tear’. As a result, the focus of medical practitioners has been on treating the disorder – by repairing or replacing the valve – rather than preventing it. This is partly because there has been a lack of large-scale, longitudinal studies investigating the effect of risk factors on the condition.
We set out to analyse data on 5.5 million patients in the UK over 10 years. Our findings show, for the first time, that elevated blood pressure is an important risk factor for mitral regurgitation. Consistent with prior evidence on blood pressure associations with other cardiovascular disease - such as stroke and heart attacks – we found an association with mitral regurgitation that is continuous across the whole spectrum of blood pressure. More specifically, every 20 mmHg higher baseline systolic blood pressure is associated with a 26% increased risk of mitral regurgitation, with no threshold below or above which this relationship is not true.
The association we found was only partially mediated by conditions that are established causes of secondary mitral regurgitation, which suggests that high blood pressure has a direct and independent effect on valve degeneration.
Dr. McNaughton[/caption]
MedicalResearch.com Interview with:
Candace D. McNaughton, MD MPH FACEP
Assistant Professor
Emergency Medicine Research
Department of Emergency Medicine, Research Division
Vanderbilt University Medical Center
Medical Research: What is the background for this study? What are the main findings?
Dr. McNaughton: Hypertension, or high blood pressure, affects 1/3rd of adults in the United States and more than 1 billion people worldwide. It is also the #1 risk factor for cardiovascular disease such as heart attack and stroke, so it is very important to treat.
The burden of hypertension in the emergency department is not well understood. The ER is not usually thought of as a place where perhaps we could or should be addressing hypertension; that has traditionally be left up to primary care providers. Through this study, our goals were to gain a better understanding of how many ER visits were either related to hypertension or were solely because of hypertension, and to determine whether this changed from 2006 to 2012.
We found that emergency room visits related to or solely for hypertension were common and that they both rose more than 20% from 2006 to 2012. Visits to the emergency department specifically for hypertension were more common among patients who were younger, healthier, and less likely to have health insurance. Despite increases in the number of ER visits related to hypertension, the proportion of patients who were hospitalized did not increase; this suggests that doctors in emergency departments may be more aware of hypertension and/or may be managing it without having to hospitalize patients.
Dr. Yang[/caption]
MedicalResearch.com Interview with:
Quanhe Yang, PhD
Division for Heart Disease and Stroke Prevention
Centers for Disease Control and Prevention
Atlanta, GA 30341
MedicalResearch: What is the background for this study? What are the main findings?
Dr. Yang: Body mass index (BMI) is an important risk factor for high blood pressure among adolescents. Despite a recent leveling off in the numbers of overweight and obese youths, weight-associated health outcomes remain a problem in the U.S. Some researchers have suggested that the increased prevalence of high blood pressure among adolescents is associated with the epidemic of overweight and obesity in the U.S.
As a result, we analyzed trends in pre-high blood pressure and high blood pressure among U.S. youth using data from a series of National Health and Nutrition Examination Surveys. Nearly 15,000 adolescents between the ages of 12 and 19 were included in the surveys, which were conducted between 1988 and 2012.
During that 24-year timeframe, the prevalence of high blood pressure actually decreased overall, while pre-high blood pressure remained largely unchanged. However, those rates differed based on body weight category. For example, pre-high blood pressure was consistently higher among overweight/obese adolescents (18 to 22 percent) than those of normal weight (11 to 12 percent). The observed changes in both pre-high blood pressure and high blood pressure prevalence were consistent across age group, sex and race/ethnicity.