Understanding Young Age Onset Hypertension
Hypertension is defined as consistently elevated blood pressure readings of 140/90 mmHg or higher. Young Age Onset Hypertension (YAOH) refers to high blood pressure diagnosed in individuals who are younger, typically below the age of 40. Unlike hypertension in older adults, which is often associated with lifestyle factors and age-related changes in blood vessels, YAOH is more likely to be indicative of underlying hormonal conditions. This condition is especially concerning because it often goes unrecognised and untreated, thus frequently leading to serious complications like coronary artery disease and significant organ damage.
Causes of YAOH
YAOH can be a result of a combination of the following factors:
- Genetic Predisposition: People with a family history of hypertension or genetic disorders may be more susceptible to YAOH.
- Endocrine Disorders:
- Primary Aldosteronism: This condition causes an overproduction of aldosterone, leading to sodium retention, increased blood volume, and high blood pressure, which contributes to early-onset hypertension (YAOH).
- Pheochromocytoma: Tumours of the adrenal gland produce excess adrenaline and noradrenaline, triggering episodic hypertension, often resulting in YAOH due to extreme spikes in blood pressure.
- Thyroid Dysfunctions: Hyperthyroidism can lead to tachycardia and elevated cardiac output, contributing to elevated blood pressure and the development of YAOH.
- Cushing’s Syndrome: Excess cortisol (stress hormone) can cause weight gain and high blood pressure.
- Lifestyle Factors: Poor diet (high in salt, fat, and cholesterol), lack of physical activity, excessive alcohol intake, and smoking can also contribute to YAOH.
YAOH may also be caused by renal and heart conditions. At Harmony Thyroid, Endocrinology and Diabetes Centre, our specialist clinic in Singapore focuses on diagnosing and treating hormonal imbalances contributing to hypertension in younger adults.
Symptoms of YAOH
Many young individuals with hypertension are asymptomatic. However, in the event symptoms do appear, they might include the following:
- Headaches: Often severe, especially in the morning.
- Dizziness: This may occur along with visual blurring.
- Nosebleeds: Occur more frequently due to elevated blood pressure.
- Shortness of breath: Difficulty breathing, especially during physical activity.
- Heart palpitations: A rapid or irregular heartbeat.
- Chest pain: Can occur during severe episodes of hypertension.
These symptoms generally occur when blood pressure has reached dangerously high levels or when hypertension has persisted for a prolonged time, thereby affecting the cardiovascular system more significantly.
High blood pressure typically shows no early symptoms. If you’re a young adult with risk factors, it’s crucial to monitor your blood pressure regularly. Early detection helps prevent severe cardiovascular issues such as strokes or heart attacks.
Diagnosis of YAOH
At Harmony Thyroid, Endocrinology and Diabetes Centre, Dr Vikram Sonawane, our experienced endocrinologist in Singapore, will conduct a thorough clinical assessment that usually includes:
- Routine Blood Pressure Checks: Regular monitoring of blood pressure, particularly for those who have risk factors, can help to detect hypertension early.
- Detailed Physical Examination: A detailed physical examination should be undertaken, focusing on signs of secondary hypertension and evidence of end-organ damage.
- Blood Tests and Urine Analysis: Check for underlying disorders, such as kidney issues or hormonal imbalances, that might lead to hypertension.
- Echocardiogram or Ultrasound: Examine heart and kidney health.
- Lifestyle and Medical History Evaluation: Identify potential causes related to lifestyle or other health conditions.
Treatment and Management for YAOH
Dr Vikram will tailor your treatment plan according to your condition, which typically includes:
- Medication: Depending on the cause, medications such as ACE inhibitors, angiotensin II receptor blockers, beta-blockers, or diuretics may be prescribed.
- Complication Screen: Tailored according to the clinical findings to assess hypertension-related eye, heart and lipid complications.
- ECG: An ECG (Electrocardiogram) is a medical test that measures the heart’s electrical activity to assess the heart’s rhythm, detect abnormalities, and monitor overall heart health.
- Lifestyle Changes: Significant modifications in diet and exercise are often recommended to help manage hypertension. This includes reducing salt intake, avoiding high-cholesterol foods, quitting smoking, limiting alcohol consumption, and maintaining a regular exercise routine.
- Monitoring and Regular Check-ups: Frequent monitoring of blood pressure and regular check-ups with an Endocrinologist is crucial to managing the condition effectively.
Living with YAOH
Living with hypertension at a young age requires being mindful of health and maintaining well-being. It involves adhering to treatment plans, making lifestyle changes, and regularly consulting with Endocrinologists to prevent complications. Additionally, individuals with YAOH should be aware of their condition’s potential impacts on their long-term health and take proactive steps to mitigate these risks.
If you or your loved ones are suffering from young-age onset hypertension, please schedule an appointment with our Senior Consultant Endocrinologist, Dr Vikram, from Harmony Thyroid, Endocrinology, and Diabetes Centre.
