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Annals of Internal MedicineBlood Pressure Level in Late Adolescence and Risk for Cardiovascular Events

New Study Finds Gradual Increase in Cardiovascular Risks Starting at 120/80 mm Hg in Late Adolescence

A recent cohort study conducted in Sweden has shed light on the long-term implications of elevated blood pressure (BP) in late adolescence. The study, which followed more than 1.3 million males conscripted into the military, reveals a significant association between BP levels in late adolescence and the risk of major cardiovascular events later in life.

HCN Medical Memo
These findings underscore the importance of early BP monitoring and intervention in adolescents. Elevated BP levels as early as late adolescence can be indicative of significant cardiovascular risks in the long term, warranting proactive measures to manage and mitigate these risks.

Study Design
  • Setting: Sweden
  • Participants: Males in late adolescence conscripted into the military from 1969 to 1997
  • Measurements: Baseline BP measured at conscription; primary outcome was a composite of cardiovascular death or first hospitalization for myocardial infarction, heart failure, ischemic stroke, or intracerebral hemorrhage.

The risk of major cardiovascular events increases gradually, starting at a BP level of 120/80 mm Hg in late adolescence.

Key Findings
  • 28.8% of participants had elevated BP (120 to 129/<80 mm Hg), and 53.7% had hypertensive BP (≥130/80 mm Hg)
  • During a median follow-up of 35.9 years, 79,644 participants experienced a primary outcome
  • Adjusted hazard ratios increased with BP stages, ranging from 1.10 for elevated BP to 1.71 for stage 2 systolic–diastolic hypertension (SDH)
  • Cumulative risk for cardiovascular events increased across BP stages, from 14.7% for normal BP to 24.3% for stage 2 SDH at age 68

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