Along with insulin resistance, obesity and abnormal blood cholesterol and triglyceride levels, hypertension is one of the components of metabolic syndrome, a term used to describe this common combination of health conditions. People with metabolic syndrome are at higher risk for developing type 2 diabetes, and younger adults with type 2 may be at higher risk for cardiovascular events — like a stroke — than other young people without diabetes.
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In the latest study, researchers looked at 5,079 young and middle-aged adults, with an average age of 30, for a total of nine examinations between 1985 and 2016. As noted in a Healio article on the study, participants were categorized as having normal blood pressure, elevated blood pressure, stage 1 hypertension (systolic pressure of 130–139, or diastolic pressure of 80–89)) or stage 2 hypertension (systolic pressure of 140 or higher, or diastolic pressure of 90 or higher). These categories were based on the highest blood pressure taken at the third examination, as well as later examinations as needed for further analysis. Systolic blood pressure is the “top number,” measured during heartbeats, while diastolic blood pressure is the “bottom number,” measured between heartbeats.
Hypertension linked to a higher risk of stroke
During an average follow-up period of 26.1 years, 100 participants had a stroke, either fatal or nonfatal. Out of these, 65 were ischemic strokes (caused by a clot), rather than hemorrhagic strokes (caused by a bleed). The overall incidence of stroke among study participants was 76 per 100,000 person-years. This rate was similar between men and women, with men having strokes at a rate of 71 and women having them at a rate of 79 per 100,000 person-years. But there was a huge difference between white and Black participants, with white adults having strokes at a rate of 29 and Black adults having them at a rate of 120 per 100,000 person-years.
The researchers found that having stage 2 hypertension near the beginning of the study was linked to a significantly higher risk of stroke, with these participants 3.72 as likely to have a stroke right from the beginning. They were also 5.84 times as likely to have a stroke over time — including 4.14 times as likely to have a stroke at age 30, and 5.59 times as likely at age 40. After adjusting for other factors that could affect a person’s risk of stroke, the researchers found that any increase in systolic blood pressure above 90 mm Hg was linked to a higher stroke risk at age 40.
The researchers concluded that these findings call for basic prevention strategies to reduce the risk of hypertension in young and middle-aged adults, particularly Black young adults. These strategies, they noted, should also aim to reduce blood pressure “including within values traditionally considered to be normal” to reduce the risk of stroke as much as possible.
Want to learn more about managing blood pressure? Read “Treating High Blood Pressure” and “Seven Little-Known Steps for Managing High Blood Pressure.”
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