Abstract 005: Intensity of Hypertensive Exposure in Young Adulthood and Subclinical Atherosclerosis in Middle Age

Abstract

Background and aims: To measure the association between intensity of hypertensive exposure and coronary artery calcification (CAC) during a 25-year period in young adulthood. Methods: The Coronary Artery Risk Development in Young Adults (CARDIA) Study enrolled 5,115 healthy black and white American aged 18-30 years at baseline (March 1985-June 1986 to June 2010-May 2011). Durations of hypertension was estimated based on their identification at examinations 7, 10, 15, 20, and 25 years later, and cumulative BP exposure (millimeters of mercury х year) were used to represent long-term exposure to BP levels. CAC was identified by computed tomography (CT) at years 15, 20, and 25. Results: Among 2057 participants at year 0, 30.8% (634 of 2057) developed stage 1 hypertension and 13.8% (284 of 2057) developed stage 2 hypertension. After adjustment, the hazard ratio for the presence CAC was 1.07 (95% CI 0.99, 1.17) and 1.14 (95% CI 1.02, 1.29) times higher for each follow-up years longer duration of stage 1 and stage 2 hypertension respectively. For cumulative BP exposure at year 25, the odds ratio (ORs) for CAC were 1.58 (95% CI 1.39, 1.80) in cumulative SBP, 1.45 (95% CI 1.28, 1.64) in cumulative DBP, 1.26 (95% CI 1.13, 1.41) in cumulative PP, and 1.55 (95% CI 1.36, 1.76) in cumulative MAP for each SD increment. Conclusions: In early adulthood, more severe intensity of hypertensive exposure, durations of hypertension or exposure to BP, is associated with subclinical atherosclerosis in middle age. Key Words: coronary artery calcification, hypertension, young adult