A study of long-term observations in borderline hypertension
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Borderline hypertension poses risks for developing established hypertension and cardiovascular issues. Early intervention focusing on obesity and glucose intolerance is crucial for managing borderline hypertension and preventing complications.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- Borderline hypertension affects 18.2% of the Japanese urban population studied.
- Understanding risk factors for progression to established hypertension is critical for cardiovascular disease prevention.
Purpose of the Study:
- To identify risk factors for borderline hypertension progression to established hypertension.
- To investigate the relationship between initial clinical features and 10-year blood pressure changes.
- To assess cardiovascular complications in borderline hypertensive individuals.
Main Methods:
- Longitudinal study of a Japanese urban population over 10 years.
- Classification of subjects based on blood pressure changes into five groups.
- Analysis of clinical features including obesity and glucose intolerance in relation to hypertension development.
Main Results:
- 19.0% of borderline hypertensives developed established hypertension; 27.4% fluctuated between borderline and established hypertension.
- Obesity and glucose intolerance were significantly more prevalent in those who developed established hypertension.
- Cardiovascular complications like ECG abnormalities and retinopathy were observed even in borderline hypertensives.
Conclusions:
- Borderline hypertension requires continuous medical management.
- Interventions targeting obesity and glucose intolerance are essential for preventing established hypertension.
- Early detection and management of borderline hypertension can mitigate cardiovascular risks.
Abstract:
To identify the risk factors of borderline hypertension in the development of established hypertension, the relationship between the changes in blood pressure over 10 years and the clinical features in the initial year was investigated in a Japanese urban population. The occurrence of cardiovascular complications in cases with borderline hypertension were also studied. The prevalence of borderline hypertension in the initial year was 18.2%. On the basis of the blood pressure changes over 10 years, these subjects could be classified into the following 5 groups: (I) those with developing established hypertension, 19.0%; (II) those with fluctuating between hypertension and borderline hypertension, 27.4%; (III) those with remaining with borderline hypertension, 19.6%; (IV) those with fluctuating between borderline hypertension and normotension, 22.9%; (V) those with improving to normotension, 11.2%. The later development of established hypertension was found in only 2.4% of normotensives in the initial year. Obesity and glucose intolerance were more frequently observed in group I (38.2% and 29.4%, respectively) than in the other groups. Diastolic blood pressures in the initial year were significantly higher in groups I and II than in III, IV and V. As for the occurrence of cardiovascular complications during the observation period, electrocardiographic abnormalities and hypertensive and/or arteriosclerotic retinopathy were not infrequently observed even in borderline hypertensives. Therefore, in subjects with borderline hypertension, continuous medical management, including correction of obesity as well as glucose intolerance, is necessary to prevent the development of established hypertension and subsequent cardiovascular complications.