Clinical Correlates of Early-Onset Hypertension

Background Early-onset hypertension has been established as a heritable trait and a risk factor for cardiovascular disease outcomes. However, the clinical correlates of early-onset hypertension remain unidentified. Methods In this study we assessed the demographic characteristics and lifestyle factors related to hypertension onset age in a sample of 3286 Coronary Artery Risk Development in Young Adults (CARDIA) study participants (mean baseline age 25±4 years, 57% women). We examined the association between the participants’ baseline characteristics and age of hypertension onset subgroups (<35 years, 35‒44 years or ≥45 years) using a multinomial logistic regression model with those who did not develop hypertension as the reference group. Hypertension onset was defined as blood pressure ≥140/90 mmHg or antihypertensive medication use on two consecutively attended follow-up visits. Results In the multinomial logistic regression model, individuals who were black (OR, 5.08; 95% CI, 3.17–8.14), were more obese (OR, 1.57; 95% CI, 1.32–1.88), or had higher total cholesterol (OR, 1.34; 95% CI, 1.13–1.60 per SD) had increased odds of early-onset hypertension (onset at <35 years) versus not developing hypertension. In contrast, 1-SD higher HDL-cholesterol was related to decreased odds of early-onset hypertension (OR, 0.71; 0.57–0.89). The odds for having earlier hypertension onset increased linearly across age of onset categories in black individuals and individuals with lower HDL-cholesterol (p<0.05 for trend for both). Conclusions Our findings suggest that individuals who are black, obese, have higher total cholesterol, or have lower HDL-cholesterol level, are potentially at an increased risk of having early-onset hypertension.