Researchers from the University of Eastern Finland, the University of Exeter and the University of Bristol conducted the study using data from one of the most extensive ongoing prospective cohort birth studies, the Avon Long-Term Study for Parents and Children (ALSPAC).
Atherosclerotic features, called arterial stiffness, appear to independently cause high blood pressure and hypertension in adolescents and young adults. The prevention and treatment of hypertension in the young population should include strategies to reduce arterial stiffness. Image credit: Andrew Agbaje.
Globally, hypertension and obesity are major preventable risk factors for atherosclerotic cardiovascular disease and death. However, several efforts to reduce the incidence and prevalence of hypertension and obesity have had minimal effects. Therefore, understanding the natural development and pathogenesis of hypertension and obesity is important to reduce these risks. In a newly published study, researchers examined whether atherosclerotic traits such as arterial stiffness temporarily preceded the development of hypertension and obesity. This is the first time that more than 3,800 adolescents aged 17 have been followed for seven years. Researchers have used several statistical approaches to unravel potential causal relationships.
The researchers found that higher arterial stiffness during adolescence increased the risk of systolic hypertension by 20 percent and diastolic hypertension by two, seven years later. In addition, participants were categorized into four equal groups according to their level of arterial stiffness. Adolescents whose levels of arterial stiffness were in the highest quartile at both 17 years of age and 24 years of age had an increase in systolic blood pressure of 4 mmHg and their diastolic blood pressure increased by 3 mmHg during the seven-year observation period. It should be noted that a slight increase in systolic and diastolic blood pressure is also observed in adolescents with slightly increased arterial stiffness, but within normal limits. However, the change in blood pressure in the “light” group is half as small as the change in the “high” group. These results are similar in both men and women, despite the control of important risk factors such as smoking, physical activity, lipids and glucose, body fat, heart rate, family history of cardiovascular disease and others.
Previous studies have focused on the adverse effects of obesity on the heart and blood vessels. However, the present study found that higher arterial stiffness at age 17 increased the risk of abdominal obesity and whole body obesity by 20 percent at age 24. The results reveal a possible two-way street between unhealthy arteries and obesity, although the evidence is stronger for obesity leading to unhealthy arteries, not the other way around.
A recent scientific statement from the American Heart Association notes that “lifestyle changes, including diet, reduced sedimentation and increased physical activity, are generally recommended for obese patients; however, the long-term success of these strategies to reduce obesity, maintain weight loss, and lower blood pressure is limited. ” It has also been found that a 5 mmHg increase in blood pressure over five years increases the risk of death in the adult population by 16 percent.
Therefore, our new findings are clinically significant for the health of the population, as future strategies for the prevention and treatment of hypertension and obesity may now consider reducing arterial stiffness, especially in adolescence.
Andrew Agbaje, Physician and Clinical Epidemiologist, University of Eastern Finland
This study was supported in part by research grants from the Jenny and Anti Vihuri Foundation, the Central Fund of the Finnish Cultural Foundation, the Regional Fund of the Finnish Cultural Foundation North Savo and the doctoral program in clinical research, the Faculty of Health Sciences, the University of Eastern Finland. The UK Medical Research Council, the Wellcome Trust and the University of Bristol provided key support for the ALSPAC study. The figure was created with Biorender.com
University of Eastern Finland
Reference in the magazine:
Agbaje, AO, et al. (2021) Effects of arterial stiffness and progression of carotid intima-media thickness on the risk of overweight / obesity and high blood pressure / hypertension: a cross-cohort study. Hypertension. doi.org/10.1161/HYPERTSIONAHA.121.18449.