Blood pressure must be controlled in midlife before irreversible damage is done

This week marks Know Your Numbers Week, a Blood Pressure UK initiative which aims to encourage people to know their blood pressure levels. Most people will have heard of high blood pressure. But what a lot of people – especially those who are in midlife and younger – might not know, is how important it is for us to monitor and control it throughout our lifetime. 

We often brush it aside as something not to worry about when we’re younger, instead thinking that it is a condition we develop as we age. But now, new research on blood pressure that we have funded led by Dr Dipender Gill from Imperial College London, has shone a light on the true damage that high blood pressure can cause if left uncontrolled when we’re younger. 

High blood pressure, also known as hypertension, is when your blood pressure constantly remains above the recommended levels. High blood pressure can damage the walls of your arteries, which could lead to life threatening conditions such as coronary heart disease, heart attack or stroke. 

Damage done

Dr Gill’s research has shown that high blood pressure at age 55 and younger increases your risk of coronary heart disease independent of high blood pressure after 55 years of age. In other words, if you have had high blood pressure in your 40s, but controlled it in your 60s, then the damage is already done. 

But, as this research indicates, blood pressure can’t be left as an afterthought when we reach our golden years. 

Dr Gill, who has degrees in medicine and medical science from The Queen’s College, University of Oxford, and a PhD at Imperial College London, decided to pursue a career in medicine as it brought together his passions for science and interacting with people. 

While it is generally well known that blood pressure is a major risk factor for heart and circulatory disease, the optimal time in life to control blood pressure isn’t as clear. As many people consider blood pressure to be something that needs to be addressed in older age, Dr Gill felt that it was important to clarify that people should be monitoring their blood pressure throughout their lifetime. 

Dr Gill took some time to talk to us about why this research is so significant. 

What is significant about this research? 

This work provides evidence to support the notion that blood pressure in midlife affects risk of coronary heart disease irrespective of blood pressure in later life. Therefore, efforts to control blood pressure in midlife are likely to reduce risk of cardiovascular disease later down the line.

How was this research conducted? 

We used large-scale genetic data and applied a technique called ‘Mendelian randomisation’. With this approach, randomly allocated genetic variants that proxy the effect of modifying blood pressure were used to study effects on coronary heart disease, equivalent to random treatment allocation in a clinical trial setting. 

What is special about this particular study is that we used genetic variants related to blood pressure in midlife and adjusted for their association with blood pressure in later life. This allowed us to estimate the effect of blood pressure in midlife independently of blood pressure in later life. 

How will this research benefit people with high blood pressure? 

We hope that this research will encourage people to control their blood pressure throughout life (including in midlife), having acknowledged that this will lower their risk of getting cardiovascular disease in later life.

Why do people in midlife often not think about monitoring blood pressure? 

There may be the perception that blood pressure is only something that needs to be worried about in later life. Our research provides evidence to suggest that this is not the case. 

What lifestyle factors contribute towards high blood pressure? 

A number of lifestyle factors can contribute towards raised blood pressure, including lack of exercise, poor diet (including eating too much salt and drinking too much alcohol) and smoking. 

Regular exercise can reduce your risk of high blood pressure. It is recommended that you do at least 150 minutes of moderate intensity physical activity a week. That doesn’t mean you have to run a marathon, but simple things like getting off the bus a stop early and walking the rest of the way or going for a brisk stroll on your lunch break can help make a difference. 

If you think you are at risk of having high blood pressure, or if your readings are higher than normal, then make an appointment with your GP.

Manage your blood pressure at home