[Skip to Content]
[Skip to Content Landing]
Views 1,664
Citations 0
November 6, 2018

High Blood Pressure in Young Adulthood and Risk of Premature Cardiovascular DiseaseCalibrating Treatment Benefits to Potential Harm

Author Affiliations
  • 1Section of Preventive Medicine and Epidemiology, Boston University School of Medicine, Boston, Massachusetts
  • 2Section of Cardiovascular Medicine, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts
  • 3Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts
  • 4Framingham Heart Study, Framingham, Massachusetts
JAMA. 2018;320(17):1760-1763. doi:10.1001/jama.2018.16068

High blood pressure poses a major public health problem worldwide, including in the United States.1 Today, an estimated 1.13 billion people worldwide have hypertension (at the cut points of either ≥140 mm Hg for systolic or ≥90 mm Hg for diastolic blood pressure).2 The prevalence of hypertension has been forecast to escalate to about 1.56 billion people by 2025.3 These statistics provoke major concern because numerous observational studies have demonstrated a continuous and graded relationship of systolic and diastolic blood pressure with the risk of cardiovascular disease (CVD) and chronic kidney disease. The vascular risk starts at measures as low as 115 mm Hg for systolic and 75 mm Hg for diastolic blood pressure, which are considered optimal levels,4 and is consistent across sexes, age groups, race/ethnic categories, and countries.5 It is estimated that about half the risk of CVD that is associated with suboptimal systolic blood pressure is attributable to values in the 130 to 150 mm Hg range.6