A multigenerational, prospective cohort study in the US concluded that early onset (age <55 years) compared with late onset hypertension was associated with greater odds of cardiovascular death and with greater risk for hypertension in offspring. The study included 3614 first generation participants with mortality data and 1635 initially non-hypertensive second generation participants with data available on parental blood pressure spanning six decades. In second generation participants, having one or both parents with late onset hypertension did not increase the risk of hypertension compared with having parents with no hypertension; by contrast, the hazard ratios of hypertension were 2.0 and 3.5 in participants with one and both parents with early onset hypertension, respectively. In first generation decedents, 1151 cardiovascular deaths occurred (including 630 coronary deaths). The odds of cardiovascular death increased linearly with decreasing age of hypertension onset. Compared with non-hypertensive participants, hypertension onset at age <45 years conferred an odds ratios of 2.2 for cardiovascular death and 2.3 for coronary death, whereas hypertension onset at age ≥65 years conferred a lower magnitude odds ratios of 1.5 for cardiovascular death and 1.4 for coronary death. The findings suggest that age of hypertension onset is a trait that both reflects a heritable predisposition for high blood pressure and offers important prognostic information in assessing an individual’s cardiovascular risk. Source: http://www.bmj.com/
