High-normal blood pressure and the risk of cardiovascular disease

Area of Science:

• Cardiology
• Hypertension Management
• Preventive Medicine

Background:

• Divergent international guidelines exist for classifying prehypertension.
• High-normal blood pressure is recognized as a cardiovascular disease (CVD) risk factor in Western countries and Japan.
• Metabolic syndrome is an emerging CVD risk factor, with its components independently associated with CVD risk.

Purpose of the Study:

• To review the classification of prehypertension and its implications for cardiovascular disease (CVD) risk.
• To highlight the significance of high-normal blood pressure and metabolic syndrome as CVD risk factors.
• To discuss updated hypertension management guidelines in Japan.

Main Methods:

• Comparative analysis of international hypertension guidelines (JNC 7, European, Japanese).
• Review of previous studies on high-normal blood pressure, metabolic syndrome, and CVD risk.
• Examination of the 2009 Japanese hypertension management guidelines.

Main Results:

• Prehypertension classification differs between US and European guidelines.
• High-normal blood pressure is a CVD risk factor, particularly when co-existing with other risk factors.
• Metabolic syndrome components are associated with CVD risk, irrespective of abdominal obesity.

Conclusions:

• Patients with high-normal blood pressure, especially those with metabolic syndrome or other risk factors, are at increased CVD risk.
• Japanese guidelines identify high-normal blood pressure patients with specific comorbidities as high-risk.
• Initiation of antihypertensive therapy is recommended for high-risk individuals with high-normal blood pressure.