Cardiovascular and Kidney Events Associated with Visit-to-Visit Blood Pressure Variability among Young Adults with...

Area of Science:

• Cardiovascular Medicine
• Nephrology
• Hypertension Research

Background:

• Blood pressure (BP) variability and long-term BP exposure are recognized risk factors for cardiorenal events.
• The prognostic significance of these factors in young adults with hypertension remains less understood.

Purpose of the Study:

• To investigate the association between visit-to-visit BP variability and cumulative BP exposure with cardiorenal events in young adults diagnosed with hypertension.

Main Methods:

• A cohort of adults aged 18-39 with stage 1 or 2 hypertension was identified from a US healthcare system (2009-2019).
• Systolic and diastolic BP variability were measured using coefficient of variation.
• Cumulative BP exposure was calculated as a time-weighted average over three years preceding the index date.
• Cox proportional hazards models were employed to assess associations with cardiovascular and kidney events, adjusting for baseline BP and covariates.

Main Results:

• The study included 151,692 young adults, with 812 cardiovascular and 1,194 kidney events observed over a median of 5.4 years.
• Both systolic BP (SBP) variability and time-weighted average SBP showed J-shaped or linear associations with cardiorenal events, particularly in stage 1 hypertension.
• In stage 1 hypertension, elevated SBP variability (90th vs. 50th percentile) increased risks for cardiovascular (HR=1.25) and kidney events (HR=1.24).
• Higher time-weighted average SBP (140 vs. 120 mm Hg) and DBP (90 vs. 80 mm Hg) were also associated with increased cardiorenal event risks.

Conclusions:

• Visit-to-visit BP variability and cumulative BP exposure emerge as significant prognostic markers for cardiorenal events in young adults.
• These findings are particularly pronounced in young adults with stage 1 hypertension, highlighting the need for close monitoring and management.