Young men who reported smoking at least 21 cigarettes per day or drinking heavily were up to 70% more likely to experience a fracture in middle-age when compared with nonsmokers or men who reported moderate alcohol consumption, according to findings published in the Journal of Bone and Mineral Research.

In a prospective analysis of conscript data from Sweden, researchers also observed no association between handgrip strength measured at age 18 years and fracture risk during middle-age.

“Although previous publications have consistently reported a relationship between low handgrip strength and fractures in older men, no long-term follow-up data is available to our knowledge for young adults,” Daniel Prieto-Alhambra, MD, PhD, professor of pharmaco- and device epidemiology at Botnar Research Centre in Oxford, United Kingdom, and colleagues wrote in the study background. “In parallel, evidence suggests that smoking and alcohol use could contribute to an increased fracture risk through a lower bone mineral density for smokers and a higher risk for falls and traumas for heavy alcohol drinkers.”

Prieto-Alhambra and colleagues analyzed data from 40,112 young men undergoing a conscription examination in Sweden between September 1969 and May 1970 at age 18 years. Data on muscle strength, height, weight and lifestyle factors were linked to the National Patient Register 1987-2010. Handgrip strength was considered the main exposure and smoking and alcohol consumption as secondary exposures. Outcomes were all fractures, major osteoporotic fractures and major traumatic fractures. Researchers used Cox regression models to estimate HRs according to handgrip strength as a continuous variable (per 1 standard deviation [SD]), with adjustments for weight, height, parental education, smoking and alcohol consumption.

Smoking
Young men who reported smoking at least 21 cigarettes per day or drinking heavily were up to 70% more likely to experience a fracture in middle-age when compared with nonsmokers or men who reported moderate alcohol consumption.
Source: Shutterstock

Within the cohort, median alcohol consumption was 54 g per day, and 41% of men described themselves as nonsmokers.

Researchers found that 3,974 men experienced a fracture during middle-age, for an incidence rate of 44.5 per 1,000 person-years (95% CI, 43.2-45.9). Corresponding rates for major osteoporotic fractures and traumatic fractures were 12.2 and 5.6 per 1,000 person-years, respectively.

Researchers found no association between handgrip strength and any fracture risk.

In analyses of associations between lifestyle factors and fracture risks, researchers found that men who reported smoking at least six cigarettes per day were more likely to experience a fracture in middle-age vs. nonsmokers. The adjusted HR for smoking at least 21 cigarettes per day was 1.44 for all fractures (95% CI, 1.21-1.71).

Researchers observed a J-shaped associated between alcohol consumption and fracture risk. Compared with men who reported moderate alcohol consumption, defined as between 1 g and 100 g per week, the adjusted HR for fracture risk with no alcohol consumption was 1.23 (95% CI, 1.07-1.41), whereas the HR for consuming more than 400 g per week was 1.48 (95% CI, 1.2-1.83). The estimated population attributable fraction of fractures due to smoking and excess alcohol consumption was 11.8% (95% CI 7.9-15.5).

“About 12% of midlife fractures in men could be avoided if smoking and heavy alcohol consumption were eliminated,” the researchers wrote. – by Regina Schaffer

Disclosures: The authors report no relevant financial disclosures.

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The post AHA News: High Blood Pressure Common Among Black Young Adults appeared first on MyMedicPlus.

New Delhi: While hypertension is more prevalent among the elderly, it has become an increasing trend among young adults in recent times. Hypertension or high blood pressure is a major risk factor for cardiovascular disease. Currently, Indians experience cardiovascular deaths at least a decade earlier than people in developed countries. The increased prevalence of traditional risk factors in the young population including obesity, diabetes and renal disease increase the risk of developing hypertension.

Psychosocial factors like stress, work pressure, anxiety and substance abuse like smoking, chewing tobacco and excess alcohol intake also contribute to hypertension in youngsters. Urbanization, change in diet and lower levels of physical activity are some of the major factors contributing to the rise of high blood pressure.

Hypertension in young adults

Hypertension in young may be of two types – primary or secondary, but more than 90 per cent are seen to have primary hypertension. Primary hypertension has no specific cause. It is often associated with a family history of hypertension, obesity or metabolic syndrome. Secondary hypertension can be due to renal and hormonal causes, etc. “Most young patients are asymptomatic and diagnosed during screening or when presented with an unrelated condition, and only a minority present with a hypertensive emergency,” said Dr Ravindranath Reddy DR, senior consultant, Interventional Cardiologist at BGS Gleneagles Global Hospital, Bengaluru.

Untreated hypertension damages the heart and other organs. It can lead to life-threatening conditions like heart attack, stroke and kidney damage. Hypertension is often called a silent killer because symptoms generally appear only after the disease has caused end-stage organ damage. The narrowing and blocking of blood vessels caused by high blood pressure increase the risk of developing heart failure.

High blood pressure forces the heart to work harder than necessary in order to pump blood to the rest of the body. This causes the left ventricle to thicken or stiffen (left ventricular hypertrophy). These changes limit the ventricle’s ability to pump blood to your body. This increases one’s risk of heart attack, heart failure, and sudden cardiac death. Hence, this increasing trend of hypertension in the young people calls for early surveillance and prompt treatment to prevent future cardiac events.

How to prevent and control high blood pressure

Below are some simple measures you can take to help prevent or manage hypertension:

• Avoid smoking and tobacco
• Lose weight if you’re overweight
• Get 30 minutes of moderate-intensity aerobic activity at least five days per week
• Eat a healthy diet consisting of fruits, vegetables, whole grains, and low-fat dairy products with reduced content of saturated and total fat
• Minimise your salt intake

Young adults aged <40 years should be educated about the association between body weight and hypertension. Particular caution surrounding lifestyle habits, including drinking and smoking, is warranted. It is an area where major health gains can be made through the implementation of primary care interventions and basic public health measures that target diet, lifestyle and environment.

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