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Childhood Hypertension Associated With Long-Term Cardiovascular Disease Risk
RESEARCHERS have identified an association between the diagnosis of hypertension in youths and a 2.1 times higher risk of major adverse cardiac events (MACE). The prevalence of paediatric hypertension has risen more than 5-fold in the past 30 years, affecting 6% of all children globally. This is of particular concern due to the association of paediatric hypertension with long-term subclinical cardiovascular disease. Nevertheless, there is insufficient research linking childhood hypertension to adverse cardiovascular outcomes; therefore, there may be a missed opportunity for early prevention.
A retrospective population-based cohort study was conducted in Ontario, Canada, to determine the risk of MACE in the later life of children diagnosed with hypertension. The cohort was comprised of 25,605 children diagnosed with hypertension and 128,025 matched controls (aged 3–18) from 1996–2022. Each case of paediatric hypertension was matched with five controls without hypertension matching for age, sex, birth weight, maternal gestational hypertension, prior comorbidities, and a propensity score for hypertension. Data was analysed using the Kaplan–Meier method and Cox proportional hazards regression to evaluate time to MACE.
Results revealed that participants had a median age of 27 years at the last follow-up, and that hypertension in youth was associated with a 2- to 3-fold increased risk of stroke, congestive heart failure, hospitalised myocardial infarction, coronary intervention, and unstable angina. Nonetheless, cardiovascular death was not associated with hypertension when the case and controls were compared. Researchers acknowledged the lack of access to data on additional confounding factors and effect modifiers, as well as possible cardiovascular detection bias in participants with hypertension, as limiting factors in the study.
The study concluded that the significant association of paediatric hypertension with the long-term risk of MACE justified the implementation and improvement of blood pressure screening, as well as increased patient and clinician awareness of MACE risk. The majority of children do not receive regular blood pressure screening, with over three-quarters of hypertension cases undiagnosed. Improving the detection and care of childhood hypertension may help prevent cardiovascular disease.
Reference:Robinson CH et al. Long-term cardiovascular outcomes in children and adolescents with hypertension. JAMA Pediatr. 2024;DOI:10.1001/jamapediatrics.2024.1543.
Hypertension: Number Of People Grappling With The Silent Killer Skyrockets
This surge in hypertension cases has had profound health ramifications, contributing to a staggering 10.8 million preventable deaths annually and robbing individuals of 235 million years of healthy living.
Hypertension, also known as high blood pressure, isn't just a number on a blood pressure monitor; it's a serious medical condition with far-reaching consequences. This silent killer significantly heightens the risk of heart disease, stroke, kidney issues, and a host of other ailments.
A report by the World Health Organisation (WHO) states it's a key player in triggering heart attacks, heart failure, and strokes, collectively known as cardiovascular diseases (CVD). Unchecked hypertension can inflict lifelong complications and sudden cardiovascular crises, making its control imperative.
Defined as having a systolic blood pressure (SBP) equal to or exceeding 140 mmHg or a diastolic blood pressure (DBP) equal to or surpassing 90 mmHg, hypertension doesn't discriminate. While age-related factors may contribute to elevated blood pressure, lifestyle choices play a pivotal role.
Poor dietary habits, characterized by excessive sodium intake and insufficient potassium, along with factors like obesity, alcohol consumption, tobacco use, and sedentary living, fuel the hypertension epidemic.
The key to combating hypertension lies in early detection, prompt treatment, and lifestyle adjustments targeting these behavioral risk factors. Effective management entails keeping blood pressure levels below the 140/90 mmHg threshold through a combination of medication and lifestyle modifications.
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100-year-old voter stays loyal to DA, hopes for improvement in SABy adopting healthier habits and adhering to prescribed treatments, individuals can wrestle control from this silent assailant and safeguard their long-term health.
The World Health Organization's Global Report on Hypertension in 2023 paints a sobering picture of the escalating prevalence of high blood pressure worldwide. Over the past three decades, the number of adults grappling with hypertension has nearly doubled, skyrocketing from 650 million in 1990 to a staggering 1.3 billion by 2019.
This surge in hypertension cases has had profound health ramifications, contributing to a staggering 10.8 million preventable deaths annually and robbing individuals of 235 million years of healthy living.
Alarmingly, nearly one in three adults globally is afflicted with hypertension, with males exhibiting a slightly higher prevalence than females in the under-50 age group. However, beyond the age of 50, the prevalence skyrockets to nearly 49%, ensnaring one out of every two individuals, regardless of gender.
Despite the critical importance of early diagnosis and prompt treatment, a staggering 46% of individuals with hypertension remain undiagnosed. Even among those who receive a diagnosis, a mere 42% are on treatment, with less than half of them effectively managing their blood pressure. This stark reality underscores significant gaps in diagnosis and treatment coverage, with low-income countries bearing the brunt of this health crisis.
As hypertension continues its relentless march across the globe, urgent and concerted efforts are needed to bridge these diagnostic and treatment gaps, ensuring that individuals receive the timely interventions they need to thwart this silent killer and safeguard their health and well-being.
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Global Health: Disease Risk Factors Such As Hypertension, High Blood Sugar Are On The Rise
A new study published in The Lancet reports there's been a significant increase worldwide in people experiencing disease risk factors, such as high blood pressure, high levels of cholesterol, and high body mass index (BMI).
The latest findings from The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021unveiled new insights into health challenges and what's driving them.
Those factors are associated with metabolism and include high systolic blood pressure (SBP), high fasting plasma glucose (FPG), high body mass index (BMI), high LDL cholesterol, and kidney dysfunction.
All demonstrate what researchers call "the consequences of an aging population and changing lifestyles on a global scale."
According to the study – done by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington – the world experienced a 49% increase in the number of global DALYs, or disability-adjusted life years (lost years of healthy life due to poor health and early death), attributable to metabolism-related risk factors between 2000 and 2021.
Researchers reported that poor health in people 15 to 49 years old was increasingly attributable to a high BMI and high FPG – also known as high blood sugar – that increases the risk of developing type 2 diabetes.
Other metabolic risk factors, such as high LDL cholesterol and SBP, landed in the top 10 risk factors for people in this age group.
"Though metabolic in nature, developing these risk factors can often be influenced by various lifestyle factors, especially among younger generations," said Dr. Michael Brauer, an affiliate professor at IHME, in a statement. "They also are indicative of an aging population that is more likely to develop these conditions with time."
"Targeting the reduction of preventable, non-communicable diseases through modifiable risk factors presents an enormous opportunity to pre-emptively alter the trajectory of global health through policy and education," Brauer added.
The study authors said their analysis presents comprehensive estimates of the disease burden of 88 risk factors and their associated health outcomes for people for 204 countries and territories from 1990 to 2021.
They said the study incorporates IHME's new burden of proof methodology for the first time, which "rigorously evaluates the evidence linking risk factors, diseases, and injuries, and offers an additional lens through which to prioritize actions and highlight areas in need of further research."
Among the biggest contributors to DALYs in 2021 were particulate matter air pollution, smoking, and low birthweight and short gestation, with considerable variation across ages, sexes, and locations.
However, the researchers also said that substantial progress happened between 2000 to 2021 to reduce worldwide burden of disease attributable to risk factors linked to unsafe water, sanitation, maternal and child health, and household air pollution from cooking with solid fuels.
"Risk factors that currently lead to ill health, such as obesity and other components of metabolic syndrome, exposure to ambient particulate matter air pollution, and tobacco use, must be addressed via a combination of global health policy efforts and exposure reduction to mitigate health risks and improve population health," said Dr. Emmanuela Gakidou, a professor of health metrics sciences at IHME, in a statement.
"With increasing exposure to risk factors such as high blood sugar, high blood pressure, low physical activity, and diet high in sugar-sweetened beverages — there is an urgent need for interventions focused on obesity and metabolic syndromes," said Dr. Greg Roth, the director of the program in cardiovascular health metrics and an adjunct associate professor of health metrics sciences at IHME.
The researchers also said future trends may be quite different than past trends because of climate change and other factors such as increasing obesity and addiction.
"But, at the same time, there are tremendous opportunities to alter the trajectory of health in the next generation," said Dr. Liane Ong, a lead research scientist at IHME.
The team said declines in disease burden for risk factors related to maternal and child health and unsafe water, sanitation, and handwashing were largely due to decreases in risk exposure but also to proportionally smaller infant and youth populations.
The authors said the improvements suggest public health measures and humanitarian health initiatives over the past three decades have succeded, with high rates of decline in risk factors in areas ranking lower on the socio-demographic Index, which measures income, fertility, and education.
There were also considerable declines in the global disease burden associated with child and maternal malnutrition risk factors, such as child growth failure. Age-standardized attributable DALY rates decreased by 71%, between 2000 and 2021. Low birthweight and short gestation rates decreased by 33% during the same period.
The study authors said that despite decreases at the global level, the disease burden attributable to risk factors related to child and maternal malnutrition remained high in super-regions of sub-Saharan Africa as well as areas of North Africa and the Middle East, South Asia, and parts of East Asia, Southeast Asia and Oceania.
Disease burden associated with unsafe water sources, bad sanitation, and no access to a handwashing facility (all top-25 risks) declined, with respective decreases of 66%, 69%, and 65%, in attributable age-standardized DALY rates.
However, the burden attributable to smoking (age-standardized risk-attributable DALYs) rose moderately, due to an aging population, even though people's exposure to smoking declined.
The researchers said that could be explained by disease burden (age-standardized risk-attributable DALYs) from ambient particulate air pollution, high BMI, high FPG, and high SBP, which increased substantially as people's exposure increased and populations aged.
Dr. Cheng-Han Chen, an interventional cardiologist and the medical director of the Structural Heart Program at MemorialCare Saddleback Medical Center in California, told Medical News Today that the GBD highlights continuing lifestyle choices leading to worsening metabolic markers, which in turn will likely lead to worse clinical outcomes.
"While metabolic syndrome is a condition we are all too familiar with in the United States, it is concerning to see that lifestyle changes spreading throughout the world are now leading to wider prevalence of metabolic syndrome in areas less accustomed to this condition," said Chen, who wasn't involved in the research.
Chen added that it's "imperative" we focus global health resources on addressing many of the modifiable metabolic risk factors
"Public health campaigns can promote the importance of such interventions as healthier eating and regular exercise," he said. "If the trendline is not changed, we will be looking at a worsening global burden of cardiovascular and other metabolic diseases in the coming years."
Dr. Mir Ali, a bariatric surgeon and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in California, told Medical News Today the findings aren't surprising.
"There have been other studies that have shown a global increase in obesity and the secondary health effects associated with obesity," said Ali, who wasn't involved in the research. "Why this is happening is multifactorial and a difficult problem to solve."
Ali theorized there's been a gradual shift from primarily farming and agriculture to more industrialized society, so people in general have become more sedentary. Also, as technology progresses, there is even less need to leave the house.
He also said there's easier and cheaper access to highly processed, less healthy foods.
"There is little education about healthy eating and exercise, especially in the U.S., from an early age," Ali said. "So, a way to intervene is to start early with education about diet and exercise, so as children get older they are more likely to choose healthier foods and stay active.
Ali said finding ways to reduce the cost of whole foods and minimally processed foods is another issue that needs addressing.
"These are difficult issues to address, and it will likely take many years to see any meaningful change in a positive direction," Ali said.
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