Long-term Outcomes of Hypertension and Antihypertensive Drugs in Healthy Young Adults: A Nationwide Population-Based Prospective Cohort Study in Korea

Abstract

Objectives: To investigate the effect of hypertension (HTN) and antihypertensive medications on the incidence of cardiovascular disease in healthy young adults (approximately 20 to 45 years). Patients and Methods: In total, 4,590,597 young Korean adults without comorbidities who underwent regular health examinations were included in this study. They were stratified into 4 groups according to their blood pressure (BP) (optimal BP, normal BP, high normal BP, and HTN). The primary outcome was a composite of the incidence of myocardial infarction and ischemic and hemorrhagic stroke, obtained by tracking the medical use data of the first-ever International Classification of Diseases, Tenth Revision codes. Subgroup analysis was conducted by categorizing the HTN group into 2 subgroups according to the prescription ratios of the antihypertensive drugs during the follow-up period. Results: The average age was 33.8 years, and the median follow-up duration was 15.9 years. Hypertension elevated the incidence risk of major cardiovascular disease by 2.16 times compared with that of the optimal BP group. Dyslipidemia and HTN were the most dominant risk factors for myocardial infarction and stroke, respectively. In the subgroup analysis, antihypertensive medications decreased the incidence of cardiovascular disease by 70% in all diseases. Conclusion: Cardiovascular risk factors, including HTN, contribute to major cardiovascular disease incidence in young adults. Antihypertensive medications decreased the major cardiovascular disease incidence estimates.