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Risk factors for arterial hypertension in adults with initial optimal blood pressure: the Strong Heart Study

Giovanni de Simone1, Richard B Devereux, Marcello Chinali

  • 1Weill Medical College, Cornell University, New York, NY 10021, USA. simogi@unina.it

Hypertension (Dallas, Tex. : 1979)
|December 29, 2005
PubMed

Insights

Metabolic factors and changes over time predict arterial hypertension development in adults with optimal blood pressure (BP). Factors like waist circumference, HDL cholesterol, and diabetes are key indicators for hypertension risk.

Area of Science:

  • Cardiovascular Medicine
  • Metabolic Health
  • Hypertension Research

Background:

  • Arterial hypertension development in adults with initially optimal blood pressure (BP) is not fully understood.
  • Metabolic factors and their longitudinal changes may influence hypertension incidence.
  • American Indians have a high prevalence of obesity, a key metabolic risk factor.

Purpose of the Study:

  • To analyze associations between optimal BP, metabolic risk factors, and their changes over time with incident hypertension.
  • To identify predictors of 8-year incident arterial hypertension in a cohort with initially optimal BP.
  • To explore the role of metabolic variations in hypertension development.

Main Methods:

  • Analysis of a cohort of 967 American Indians with optimal BP and no cardiovascular disease.
  • Evaluation of baseline BP, metabolic factors (glucose tolerance, lipids, waist circumference), and their changes over 4 years.
  • Assessment of 8-year incident arterial hypertension using longitudinal data.

Main Results:

  • In participants with normal glucose tolerance, baseline BP and decreased HDL cholesterol were potent predictors.
  • Baseline waist circumference, its increase, BP increase, and diabetes at follow-up also predicted hypertension.
  • In participants with impaired glucose tolerance or diabetes, diabetes at follow-up was the strongest predictor, followed by increases in BP and LDL cholesterol.

Conclusions:

  • Incident arterial hypertension can be predicted by initial metabolic profile and unfavorable metabolic variations over time.
  • Increasing abdominal obesity and abnormal lipid profiles are major predictors of hypertension development, even at optimal initial BP.
  • Findings suggest potential implications for primary cardiovascular prevention strategies.

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