Association Between Young Adult Characteristics and Blood Pressure Trajectories

Abstract

Background: Blood pressure (BP) trajectories from young adulthood through middle age are associated with cardiovascular risk. We examined the associations of hypertension risk factors with BP trajectories among a large diverse sample.

Methods and results: We analyzed data from young adults, aged 18 to 39 years, with untreated BP <140/90 mm Hg at baseline from Kaiser Permanente Southern California (N=355 324). We used latent growth curve models to identify 10-year BP trajectories and to assess the associations between characteristics in young adulthood and BP trajectories. We identified the following 5 distinct systolic BP trajectories, which appeared to be determined mainly by the baseline BP with progressively higher BP at each year: group 1 (lowest BP trajectory, 7.9%), group 2 (26.5%), group 3 (33.0%), group 4 (25.4%), and group 5 (highest BP trajectory, 7.3%). Older age (adjusted odds ratio for 30-39 versus 18-29 years, 1.23 [95% CI, 1.18-1.28]), male sex (13.38 [95% CI, 12.80-13.99]), obesity (body mass index ≥30 versus 18.5-24.9 kg/m², 14.81 [95% CI, 14.03-15.64]), overweight (body mass index 25-29.9 versus 18.5-24.9 kg/m², 3.16 [95% CI, 3.00-3.33]), current smoking (1.58 [95% CI, 1.48-1.67]), prediabetes (1.21 [95% CI, 1.13-1.29]), diabetes (1.60 [95% CI, 1.41-1.81]) and high low-density lipoprotein cholesterol (≥160 versus <100 mg/dL, 1.52 [95% CI, 1.37-1.68]) were associated with the highest BP trajectory (group 5) compared with the reference group (group 2).

Conclusions: Traditional hypertension risk factors including smoking, diabetes, and elevated lipids were associated with BP trajectories in young adults, with obesity having the strongest association with the highest BP trajectory group.

Keywords: blood pressure trajectories; cardiovascular risk; hypertension; young adults.

Figure 1. 10‐year SBP and DBP trajectories among young adults.

A, SBP. B, DBP. The group percentages may not add to 100% because of rounding. DBP indicates diastolic blood pressure; and SBP, systolic blood pressure.

Figure 2. Multivariable adjusted OR (95% CI) of each 10‐year SBP trajectory group (vs blood pressure trajectory group 2) by young adult characteristics.

This analysis included all young adult characteristics simultaneously in the same model from group 1 (lowest level of blood pressure trajectory) to group 5 (highest level of blood pressure trajectory). Reference=group 2. BMI indicates body mass index; HDL‐C, high‐density lipoprotein cholesterol; LDL‐C, low‐density lipoprotein cholesterol; OR, odds ratio; and SBP, systolic blood pressure.