Adolescent blood pressure and subsequent mortality

January 01, 0001

Adolescent blood pressure and subsequent mortality

These Swedish researchers examined the relationship of blood pressures in late adolescence to later mortality via a nationwide cohort study. Participants were Swedish men (n=1,207,141) who had been conscripted into the armed forces. The mean age at initiation was 18.4 years and the enrollees were followed up for a median of 24 years.

The researchers found: "During follow-up, 28?934 (2.4%) men died. The relation of systolic blood pressure to total mortality was U shaped, with the lowest risk at a systolic blood pressure of about 130 mm Hg. This pattern was driven by the relation to non-cardiovascular mortality, whereas the relation to cardiovascular mortality was monotonically increasing (higher risk with higher blood pressure). The relation of diastolic blood pressure to mortality risk was monotonically increasing and stronger than that of systolic blood pressure, in terms of both relative risk and population attributable fraction (deaths that could be avoided if blood pressure was in the optimal range). Relations to cardiovascular and non-cardiovascular mortality were similar, with an apparent risk threshold at a diastolic blood pressure of about 90 mm Hg, below which diastolic blood pressure and mortality were unrelated, and above which risk increased steeply with higher diastolic blood pressures."

The researchers concluded: "In adolescent men, the relation of diastolic blood pressure to mortality was more consistent than that of systolic blood pressure. Considering current efforts for earlier detection and prevention of risk, these observations emphasise the risk associated with high diastolic blood pressure in young adulthood."

Blood pressure in adolescence, particularly diastolic blood pressure, was linked with subsequent mortality

For the full abstract, click here.

BMJ 342:d643, 22 February 2011
© 2011 BMJ Publishing Group Ltd.
Association of blood pressure in late adolescence with subsequent mortality: cohort study of Swedish male conscripts. Johan Sundström, Martin Neovius, Per Tynelius, Finn Rasmussen. Correspondence to J Sundström:

Category: K. Circulatory. Keywords: blood pressure, systolic, diastolic, adolescence, mortality, cohort study, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 8 March 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.