Age of Hypertension Onset: Overview of Research and How to Apply in Practice
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PREVENTION OF HYPERTENSION: PUBLIC HEALTH CHALLENGES (Y YANO, SECTION EDITOR)
Age of Hypertension Onset: Overview of Research and How to Apply in Practice Karri Suvila 1,2 & Ville Langén 1,3 & Susan Cheng 4,5 & Teemu J. Niiranen 2,6 Published online: 27 August 2020 # The Author(s) 2020
Abstract Purpose of Review To review the current evidence on research related to age of hypertension onset—its definition, correlates, heritability, and association with adverse outcomes. We also propose a framework for implementing assessment of hypertension onset age into clinical practice. Recent Findings Prior studies have used both objective measurements and self-report to determine age of hypertension onset or early-onset hypertension. Yet, no criterion for standard definition currently exists for either. Data from epidemiological and clinical studies demonstrate that early-onset hypertension is a highly heritable trait that confers an increased risk for cardiovascular death and end-organ damage compared with late-onset hypertension. Summary Literature to date suggests that (parental) age of hypertension onset can be feasibly assessed for estimating (1) risk of future hypertension in non-hypertensive persons; and (2) the propensity for cardiovascular disease in individuals with established hypertension. Keywords Blood pressure . Hypertension . Age of hypertension onset . Hypertension heritability . Hypertension and cardiovascular disease . Clinical implications
Introduction Elevated blood pressure (BP) affects over 1 billion people globally and is known to be highly age-dependent [1–5]. The patterns of BP progression over age in the general This article is part of the Topical Collection on Prevention of Hypertension: Public Health Challenges * Karri Suvila [email protected] 1
Division of Medicine, Turku University Hospital, Turku, Finland
2
Department of Internal Medicine, University of Turku, Turku, Finland
3
Department of Geriatrics, University of Turku, Turku, Finland
4
The Framingham Heart Study, Framingham, MA, USA
5
Barbra Streisand Women’s Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
6
Department of Public Health Solutions, Finnish Institute for Health and Welfare, Turku, Finland
population are well-documented. On average, systolic BP (SBP) rises throughout life in most individuals and finally reaches a plateau in late life [6]. However, BP trajectories over age can vary and are likely related to different levels of cardiovascular risk [7, 8]. Particularly, younger hypertensive individuals, who are more likely to be undiagnosed and undertreated than older patients, are at high risk of lifetime cardiovascular disease [9]. Despite chronological age being the strongest risk factor for both hypertension and cardiovascular disease, limited focus has been given until recently to age of hypertension onset as a potential risk factor in patients. Several prior studies have examined age of disease onset and its impact on adverse outcomes in the context of chronic diseases, such
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