Related Experiment Video
Updated: Nov 8, 2025
Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
Published on: April 23, 2021
Clinical Correlates of Early-Onset Hypertension
Karri Suvila1, Joao A C Lima2, Susan Cheng3,4,5
1Division of Medicine, Turku University Hospital and University of Turku, Turku, Finland.
Insights
Black individuals, obesity, high total cholesterol, and low HDL-cholesterol increase early-onset hypertension risk. These factors are key clinical correlates for identifying individuals at higher risk for hypertension developing at a younger age.
Area of Science:
- Cardiovascular Disease Epidemiology
- Hypertension Research
- Genetics and Public Health
Background:
- Early-onset hypertension is a heritable condition linked to cardiovascular disease.
- Clinical factors associated with the onset age of hypertension are not well understood.
Purpose of the Study:
- To identify demographic and lifestyle factors associated with the age of hypertension onset.
- To investigate clinical correlates of early-onset hypertension in young adults.
Main Methods:
- Analysis of 3,286 participants from the Coronary Artery Risk Development in Young Adults (CARDIA) study.
- Multinomial logistic regression used to compare hypertension onset age subgroups (<35, 35-44, ≥45 years) against a no-hypertension group.
- Hypertension defined by blood pressure or medication use at consecutive visits.
Main Results:
- Black race, higher obesity, and elevated total cholesterol increased odds of hypertension onset before age 35.
- Higher HDL-cholesterol levels were associated with decreased odds of early-onset hypertension.
- A linear trend of earlier hypertension onset was observed in Black individuals and those with lower HDL-cholesterol.
Conclusions:
- Black race, obesity, high total cholesterol, and low HDL-cholesterol are significant risk factors for early-onset hypertension.
- These findings highlight key clinical correlates for identifying at-risk individuals.
- Early identification and intervention may be crucial for preventing cardiovascular outcomes in susceptible populations.
Background:
Early-onset hypertension has been established as a heritable trait and a risk factor for cardiovascular disease outcomes. However, the clinical correlates of early-onset hypertension remain unidentified.
Methods:
In this study, we assessed the demographic characteristics and lifestyle factors related to hypertension onset age in a sample of 3,286 Coronary Artery Risk Development in Young Adults (CARDIA) study participants (mean baseline age 25 ± 4 years, 57% women). We examined the association between the participants' baseline characteristics and age of hypertension onset subgroups (<35, 35‒44, or ≥45 years) using a multinomial logistic regression model with those who did not develop hypertension as the reference group. Hypertension onset was defined as blood pressure ≥140/90 mm Hg or antihypertensive medication use on 2 consecutively attended follow-up visits.
Results:
In the multinomial logistic regression model, individuals who were black (odds ratio [OR], 5.08; 95% confidence interval [CI], 3.17-8.14), were more obese (OR, 1.57; 95% CI, 1.32-1.88), or had higher total cholesterol (OR, 1.34; 95% CI, 1.13-1.60 per SD) had increased odds of early-onset hypertension (onset at <35 years) vs. not developing hypertension. In contrast, 1-SD higher high-density lipoprotein (HDL)-cholesterol was related to decreased odds of early-onset hypertension (OR, 0.71; 95% CI, 0.57-0.89). The odds for having earlier hypertension onset increased linearly across age of onset categories in black individuals and individuals with lower HDL-cholesterol (P < 0.05 for trend for both).
Conclusions:
Our findings suggest that individuals who are black, obese, have higher total cholesterol, or have lower HDL-cholesterol level, are potentially at an increased risk of having early-onset hypertension.
Related Concept Videos
01:30Hypertension III: Clinical Manifestations and Diagnostic Studies
01:28Hypertension I: Introduction
01:29Hypertension II: Pathophysiology
01:18Hypertension and Regulation of Blood Pressure
01:28Factors affecting Blood pressure
Physiological Factors:
01:30Alterations in Blood Pressure
Hypertension (High blood pressure)
Hypertension occurs when blood pressure readings consistently exceed the normal range. It is diagnosed when systolic blood pressure (the top number, indicating pressure while the heart...