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Effects of prehypertension on admissions and deaths: a simulation

Louise B Russell1, Elmira Valiyeva, Jeffrey L Carson

  • 1Institute for Health, Health Care Policy, and Aging Research, Rutgers University, New Brunswick, NJ 08901, USA. lrussell@ihhcpar.rutgers.edu

Archives of Internal Medicine
|October 27, 2004
PubMed

Insights

New guidelines identify prehypertension (systolic blood pressure 120-139 mm Hg) as a risk. Eliminating prehypertension could significantly reduce hospitalizations, nursing home admissions, and premature deaths.

Area of Science:

  • Cardiovascular Health
  • Public Health Surveillance
  • Epidemiology

Background:

  • New clinical guidelines define prehypertension (systolic blood pressure 120-139 mm Hg) as an elevated risk state.
  • Previously normal blood pressure levels are now recognized as requiring intervention.

Purpose of the Study:

  • To estimate the public health impact of prehypertension and residual hypertension.
  • To quantify the potential reduction in adverse health outcomes if prehypertension is addressed.

Main Methods:

  • Utilized a simulation model calibrated with longitudinal data from the National Health and Nutrition Examination Survey (NHANES) Epidemiologic Followup Study.
  • Applied the model to a representative sample of US adults (aged 25-74) from NHANES III.
  • Defined residual hypertension as systolic blood pressure >= 140 mm Hg, accounting for treated hypertension.

Main Results:

  • Prehypertension affected over a third of most age groups in NHANES III, except women aged 25-44.
  • Prehypertension or residual hypertension impacted approximately two-thirds of individuals aged 45-64 and 80% aged 65-74.
  • Prehypertension and residual hypertension accounted for 4.7% of hospital admissions, 9.7% of nursing home admissions, and 13.7% of deaths in the studied population.
  • Prehypertension alone was linked to 3.4% of hospitalizations, 6.5% of nursing home stays, and 9.1% of deaths.

Conclusions:

  • Prehypertension poses significant public health consequences.
  • Substantial reductions in hospitalizations, nursing home admissions, and premature mortality are achievable by eliminating prehypertension.
Abstract

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