Experts Say High Blood Pressure in Younger Adults is Leading to Strokes, Cognitive Decline

The impact of high blood pressure and the incidence of strokes, long thought to be something to watch closely later in life, may need more attention in younger years.

Two separate studies being presented today at the American Stroke Association’s International Stroke Conference point to that.

One study reports that while fewer people older than age 75 are having strokes, the incidence of stroke among adults ages 49 and younger in the United States has continued to increase over the past 30 years.

The other study found that high blood pressure among younger adults ages 20 to 40 years appears to be linked to brain changes in midlife (average age 55) that may increase the risk for later cognitive decline.

Both studies found that incidences of stroke and high blood pressure in that younger age group were prevalent in what they call the “Stroke Belt” region in the southeastern United States.

Experts say these results point to the need to focus more on blood pressure and heart health from a young age.

“More than surprised, these data support and bolster the evidence we’ve been seeing (in clinic),” Dr. Adedapo (Dapo) Iluyomade, a preventive cardiologist for Baptist Health’s Miami Cardiac & Vascular Institute in Florida, told ishonest.

“We see similarities in the preponderance of heart attacks in (younger) patients,” he added.

The high blood pressure and brain impact study, led by Dr. Christina Marie Lineback, a vascular neurology fellow at Northwestern Memorial Hospital in Chicago, looked to expand smaller studies that had found that high blood pressure disrupts the structure and function of the brain’s blood vessels, damaging regions of the brain that are critical for cognitive function.

“There are studies to suggest changes to the brain may start at a young age,” Lineback said in a news release.

“Our study provides further evidence that high blood pressure during young adulthood may contribute to changes in the brain later in life,” she added.

The stroke study, led by Audrey Leasure, BS, a fourth-year medical student at Yale University School of Medicine in Connecticut, found that while strokes incidences are flattening or even decreasing overall since 1990, doctors “are seeing more severe [impact] in the younger population.”

What does this mean

Experts say that the medical community – and society at large – needs to do a better job of reaching out and serving the younger population, particularly in historically underserved areas.

“This is not a surprise,” Leasure said. “We’ve seen hints all along.”

But Leasure hopes the extensive data, honing in on the increase of strokes in those 19 to 49 years of age, pushes the issue to the forefront.

“We’ve seen more severe (outcomes) in the younger population,” she said.

The blood pressure study focuses on the notion that blood pressure is something everyone should pay attention to from a younger age.

“The problem with blood pressure is it is largely a silent killer,” said Iluyomade. “It’s an asymptomatic disease.”

Why might it be happening?

Iluyomade believes it’s a shift in what diseases look like in modern times.

He said high blood pressure in the younger population and a higher rate of strokes are “because we are seeing diseases of abundance.”

Years ago, he explained, we mostly fought “diseases of lacking.”

Now, he said, with childhood obesity soaring (as well as obesity overall), we may need to refocus not just on care plans, but information and outreach around them.

What doctors can do

For medical professionals and patients alike, Iluyomade said, some tweaks in care are called for.

First on the agenda, he said, is realizing that blood pressure is something that should be tracked and paid attention to from a younger age.

“We write it down and move on and say we will see you in a year,” he said. “We need to keep a closer eye, as clinicians and patients.”

He believes the concept of a blood pressure reading of 120 over 80 being just fine may need revisiting.

“120 over 80 is really the upper end of normal,” he said. “In fact, 120 to 129 is the upper end of normal and can be considered pre-hypertension.”

Iluyomade would like to see this potential condition watched and treated, much in the way prediabetes is now treated.

Leasure believes that reaching both the younger and the underserved community on this topic may take change — and require platforms not traditionally used for medical intervention and outreach.

“We need more outreach and it might not look the same as it once did,” she told ishonest.

She’d like to see social media used more, sharing information, stories, and actions to take. She also believes iPhones and health apps on them could help as well.

What you can do

In the meantime, experts hope the studies spur individuals to hone in on blood pressure and stroke health more actively.

“Obesity is the biggest obstacle and challenge,” Iluyomade noted.

He said that obesity isn’t just the result of overeating. There’s also psycho- social stress and a lack of ability for many people to get out of the house.

In Miami, Iluyomade said, the city planted trees for 10 years, luring people outside to walk, bike, and move. The result, he said, was “we saw a decrease in cardiovascular incidents.”

He added the younger population should become aware of their blood pressure health and take action if needed.

“By age 20, everyone should have [an annual] blood pressure check and assessment, and should pay close attention to it,” Iluyomade said.

Some other steps he suggests include:

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