Modest Blood Pressure Increase with Age in Adults with Down’s Syndrome

Background: In the general population, blood pressure typically rises with age, but this pattern in adults with Down’s syndrome remains unclear despite their higher BMI and lower physical activity levels.

Methods: Electronic health record data from 20,831 adults with Down’s syndrome (median age 34 years) were analyzed to assess systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse pressure (PP) across age groups, sex, race, and BMI.

Results:

Median SBP increased only modestly with age (e.g., +2 mm Hg by age ≥75 vs. reference group 20–<25 years).

DBP remained stable (≤2 mm Hg difference across ages).

PP showed minimal age-related increase.

SBP and PP were slightly higher in men and positively associated with BMI (β=0.29 for SBP; β=0.14 for PP).

Conclusions: Adults with Down’s syndrome exhibit a unique cardiovascular phenotype with blunted age-related BP increases, possibly due to reduced sympathetic activity. These findings challenge assumptions about hypertension risk in this population and may inform tailored screening practices.

Background: In the general population, blood pressure typically rises with age, but this pattern in adults with Down’s syndrome remains unclear despite their higher BMI and lower physical activity levels.

Methods: Electronic health record data from 20,831 adults with Down’s syndrome (median age 34 years) were analyzed to assess systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse pressure (PP) across age groups, sex, race, and BMI.

Results:

Median SBP increased only modestly with age (e.g., +2 mm Hg by age ≥75 vs. reference group 20–<25 years).

DBP remained stable (≤2 mm Hg difference across ages).

PP showed minimal age-related increase.

SBP and PP were slightly higher in men and positively associated with BMI (β=0.29 for SBP; β=0.14 for PP).

Conclusions: Adults with Down’s syndrome exhibit a unique cardiovascular phenotype with blunted age-related BP increases, possibly due to reduced sympathetic activity. These findings challenge assumptions about hypertension risk in this population and may inform tailored screening practices.