Blood pressure and cardiovascular risk in a contemporary cohort of young adults

Previous studies suggest that blood pressure (BP) is a stronger risk factor for cardiovascular disease (CVD) in women compared to men. However, few have rigorously investigated this association in young adults with emphasis on sex differences.

In 2000, the "Oslo Health Study" (HUBRO), recruited 5933 individuals born in 1969 or 1970. By linkage with national health registries in Norway, we followed this cohort through 2024 with respect to CVD events. Multivariate Cox analyses were performed to assess the risk of CVD during follow-up. Sex-specific analyses were performed by interaction testing.

The median age at baseline was 31 years (interquartile range (IQR): 30-31), and 56% were women. The median systolic and diastolic BP was 122 (IQR 114-130) and 69 (IQR 63-75) mm Hg, respectively. After 24 years of follow-up, 158 (2.7%) CVD events had occurred. The adjusted hazard ratio (HR) (95% confidence interval) for CVD events per 10 mm Hg higher systolic and 5 mm Hg higher diastolic BP was 1.22 (1.04-1.42) and 1.20 (1.09-1.31), respectively. The HR per 10 mm Hg higher systolic BP was 1.30 (1.01-1.68) in women vs 1.15 (0.96-1.38) in men. No statistically significant sex-interaction between systolic BP and risk of CVD event was found (P = .38). The HR per 5 mm Hg higher diastolic BP was 1.20 (1.03-1.41) in women and 1.20 (1.07-1.34) in men.

In young adults from the general population, systolic and diastolic BP were related to the risk of CVD events during long-term follow-up, with similar risk in women and men.