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    Jun 26, 2015

    Borderline readings may flag heart trouble in future

    YOUNG adults whose blood pressure is at the high end of the normal range might want to start watching what they eat, exercise and even take medication.

    For they could find themselves with damaged heart muscles by middle age and full blown heart failure some years later.

    A new American study has found that even though people with blood pressure of below 140/90 were not considered to have hypertension, or high blood pressure, this was still enough to affect their hearts.

    The study of 2,479 young adults over 25 years was published in Journal Of The American College Of Cardiology.

    The top number, or systolic pressure, measures the force from the heart as it contracts; the bottom diastolic number measures the pressure in the arteries when the heart relaxes between contractions. Desired blood pressure is less than 130/80 and hypertension is when it tops 140/90.

    The study found that those with high diastolic readings were 70 per cent more likely than those with the lowest reading, of getting a treatment-resistant form of heart failure where the heart muscle is unable to relax.

    "A number of patients in our study had high-normal blood pressure in their 20s and 30s, but by the time they were 45, they had the heart function of a 75-year-old," said Joao Lima of Johns Hopkins University School of Medicine, the study's principal investigator. The study suggested that "long-term blood pressure control in early young adulthood may be important to prevent coronary heart disease".

    Cardiologists in Singapore were not surprised by the findings, saying that it was expected that damage to the heart increases as blood pressure goes up.

    Poh Kian Keong, a senior cardiologist at the National University Heart Centre, Singapore said the study "alerts people to consider medical therapy and lifestyle changes such as taking less salt" if their blood pressures are borderline normal.

    He said he has several such young patients with borderline normal blood pressure, usually caused by genetic factors.

    Associate Professor Poh said he would put these patients on medication because the study suggests that "if you don't treat them, they will be worse off in the long run".

    The lead author of the study, Satoru Kishi, a cardiologist at Mitsui Memorial Hospital in Tokyo, said the current "high normal" blood pressure may be too high and far from normal for some people.

    However, David Sim, director of the Heart Failure Programme at the National Heart Centre Singapore, said that while hypertension is a known risk factor for heart failure in elderly patients, less is known about its effect on younger patients.

    "We won't know whether the results from that study will apply to Singapore until a similar study is replicated here," he said.