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The natural history of prehypertension. A 20-year follow-up

G Pannarale1, C Moroni, M C Acconcia

  • 1Dipartimento Cuore e Grossi Vasi "Attilio Reale", Sapienza University, Rome, Italy. giuseppe.pannarale@uniroma1.it.

European Review for Medical and Pharmacological Sciences
|April 8, 2017
PubMed

Insights

Prehypertension increases cardiovascular risk. Traditional factors like high cholesterol and smoking, along with developing overt hypertension, are more predictive of adverse events than masked hypertension over 20 years.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Preventive Medicine

Background:

  • Prehypertension, defined by JNC7 guidelines (systolic 120-139 mmHg and/or diastolic 80-89 mmHg), signifies increased risk for hypertension and cardiovascular events.
  • Masked hypertension, identified via ambulatory blood pressure monitoring, presents a risk for greater target organ damage compared to normal blood pressure readings.

Purpose of the Study:

  • To assess the risk of cardiac, cerebral, and vascular events in prehypertensive individuals.
  • To compare outcomes between prehypertensive subjects with and without masked hypertension.

Main Methods:

  • A cohort of 204 asymptomatic prehypertensive subjects without prior cardiovascular disease or diabetes was studied.
  • Participants underwent clinical evaluation, ECG, lab tests, and ambulatory blood pressure monitoring, with follow-up for up to 237 months.

Main Results:

  • Twenty-seven cardiovascular events (13.2%), including abdominal aortic aneurysms, occurred during follow-up.
  • Age, total cholesterol, smoking, and the development of overt hypertension were significantly associated with cardiovascular events.
  • Masked hypertension was not found to be a significant prognostic factor.

Conclusions:

  • Traditional cardiovascular risk factors and the progression to clinically overt hypertension are more critical predictors of adverse outcomes in prehypertensive individuals than masked hypertension.
  • Long-term follow-up (20 years) indicates that established risk factors remain paramount in managing prehypertension.
Abstract

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