Is midlife blood pressure linked to heart function in later life?

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High blood pressure is associated with diastolic dysfunction, but its consequences for diastolic function across adult life were unknown. The researchers hypothesised that high blood pressure in earlier adulthood would be associated with impaired diastolic function independently of current blood pressure.

The study included 1,653 participants in the Medical Research Council National Survey of Health and Development birth cohort, who underwent investigations including echocardiography at ages 60–64. Using adjusted regression models, the researchers assessed relationships between adult blood pressure, antihypertensive treatment and echocardiographic measures of diastolic function.

Higher systolic blood pressure at ages 36, 43 and 53 predicted higher E/e' and greater left atrial volume. These associations were only partly explained by systolic blood pressure at ages 60–64 and increased left ventricular mass. Antihypertensive treatment was also associated with poorer diastolic function after adjustment for systolic blood pressure at ages 60–64. Faster increases in systolic blood pressure in midlife were also associated with poorer diastolic function.

The researchers concluded that high midlife systolic blood pressure is associated with poorer diastolic function at ages 60–64. They suggested that early identification of people with high blood pressure or rapid rises in blood pressure may be important for preventing impaired cardiac function later in life.