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Progression from prehypertension to hypertension and risk of cardiovascular disease
Yukiko Ishikawa1, Joji Ishikawa2, Shizukiyo Ishikawa1
1Division of Community and Family Medicine, Jichi Medical University School of Medicine, Shimotsuke, Tochigi, Japan.
Insights
Prehypertension increases cardiovascular disease risk, particularly after progressing to hypertension. Further research in larger cohorts is needed to confirm these findings on cardiovascular event risk.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- Prehypertension (pre-HT) is linked to increased cardiovascular disease (CVD) risk.
- It remains unclear if CVD risk is elevated during pre-HT or only after developing hypertension (HT).
Purpose of the Study:
- To investigate the association between prehypertension, progression to hypertension, and cardiovascular disease risk.
- To determine if CVD risk increases at the pre-HT stage or upon transition to HT.
Main Methods:
- Analysis of the Jichi Medical Cohort study data from 2227 Japanese adults with a median follow-up of 11.8 years.
- Evaluation of BP progression from normal or pre-HT to HT.
- Comparison of CVD event rates in subjects who progressed to HT versus those who remained normotensive or pre-hypertensive.
Main Results:
- Among normotensive subjects, 34.1% progressed to pre-HT and 6.6% to HT.
- Among pre-HT subjects, 26.1% progressed to HT.
- Progression from pre-HT to HT was associated with a 2.95-fold increased CVD risk compared to remaining at normal or pre-HT levels.
Conclusions:
- CVD risk associated with prehypertension may significantly increase after progression to hypertension.
- The study highlights the importance of monitoring BP progression.
- Larger cohort studies are recommended to validate these findings due to the limited number of CVD events observed.
Background:
Subjects with prehypertension (pre-HT; 120/80 to 139/89 mm Hg) have an increased risk of cardiovascular disease (CVD); however, whether the risk of pre-HT can be seen at the pre-HT status or only after progression to a hypertensive (HT; ≥140/90 mm Hg) state during the follow-up period is unknown.
Methods:
The Jichi Medical Cohort study enrolled 12,490 subjects recruited from a Japanese general population. Of those, 2227 subjects whose BP data at baseline and at the middle of follow-up and tracking of CVD events were available (median follow-up period: 11.8 years). We evaluated the risk of HT in those with normal BP or pre-HT at baseline whose BP progressed to HT at the middle of follow-up compared with those whose BP remained at normal or pre-HT levels.
Results:
Among the 707 normotensive patients at baseline, 34.1% and 6.6% of subjects progressed to pre-HT and HT, respectively, by the middle of follow-up. Among 702 subjects with pre-HT at baseline, 26.1% progressed to HT. During the follow-up period, there were 11 CVD events in normotensive patients and 16 CVD events in pre-HT patients at baseline. The subjects who progressed from pre-HT to HT had 2.95 times higher risk of CVD than those who remained at normal BP or pre-HT in a multivariable-adjusted Cox hazard model.
Conclusion:
This relatively long-term prospective cohort study indicated that the CVD risk with pre-HT might increase after progression to HT; however, the number of CVD events was small. Therefore, the results need to be confirmed in a larger cohort.
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