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The natural history of borderline hypertension in a Chinese population
1Hypertension Division, First Affiliated Hospital of Fujian Medical College, Fuzhou, PR China.
Insights
Borderline hypertension significantly increases stroke risk and mortality. Early treatment is recommended to prevent cardiovascular complications in these patients.
Area of Science:
- Cardiology
- Hypertension Research
- Public Health
Background:
- Borderline hypertension is a precursor to established hypertension.
- Long-term outcomes and risks associated with borderline hypertension require further investigation.
Purpose of the Study:
- To assess the long-term progression and health outcomes of borderline hypertensive patients.
- To determine the primary causes of mortality and morbidity in this cohort.
Main Methods:
- A 17-year follow-up study involving 131 borderline hypertensive patients.
- Comparison with a matched cohort of normotensive individuals (1:1 ratio).
Main Results:
- 64.6% of borderline hypertensives progressed to established hypertension.
- Total mortality was higher in borderline hypertensives (27.9 vs 13.4/1000 person-years).
- Stroke was the leading cause of death, with significantly elevated risks for occurrence and mortality.
Conclusions:
- Borderline hypertension poses a substantial risk for stroke, comparable to established hypertension.
- Intervention in borderline hypertension may be necessary to mitigate cardiovascular risks.
Abstract:
One hundred and thirty-one borderline hypertensive patients were followed up for 17 years. A cohort of normotensives strictly matched by age, sex, region and occupation served as controls (1:1). It was found that 64.6% of borderline hypertensive patients developed into established hypertensives after 17 years follow-up, 25.5% restored to normotensives and 13.8% remained unchanged. The total mortality rate of borderline hypertensives was higher than that of normotensives (27.9 vs 13.4/1000 person years), and the relative risk of total death in borderline hypertensives was 2.35. The main cause of death was stroke, accounting for 42.5% of the total death rate. The relative risk rates of occurrence and death associated with stroke were 8.3 and 11.6, respectively. It is concluded that the main complication of borderline hypertension was stroke rather than coronary heart disease, which was similar to that of established hypertension in this area. Part of the borderline hypertensives need to be treated to reduce the risk of cardiovascular complications.