30 kg/m2,
and blacks. A trend was noted toward increased risk for stroke among
subjects in groups 2 and 3, but these differences were not
significant.In the latest Joint National Committee report on hypertension (JNC 7), normal blood pressure was defined as systolic BP <120 mm Hg and diastolic BP <80 mm Hg, and prehypertension was defined as SBP of 120–139 mm Hg or DBP of 80–89 mm Hg. In a prospective cohort study, researchers evaluated cardiovascular outcomes among 8960 nonhypertensive middle-aged adults and classified them into three groups by baseline BP: (1) SBP <120 mm Hg and DBP <80 mm Hg; (2) SBP of 120–129 mm Hg or DBP of 80–84 mm Hg; (3) SBP of 130–139 mm Hg or DBP of 85–89 mm Hg. Participants were followed for an average of 12 years.
After adjustment for traditional coronary risk factors, subjects in
groups 2 and 3 showed significantly increased risk for coronary heart
disease compared with subjects in group 1 (relative risks, 1.70 and
2.44, respectively). Risk was highest among those with diabetes,
those with body-mass index
30 kg/m2,
and blacks. A trend was noted toward increased risk for stroke among
subjects in groups 2 and 3, but these differences were not
significant.
Consistent with a prior study from the Framingham cohort, these results demonstrated a significant increase in CHD risk among people with prehypertensive BP. As JNC 7 recommends, such patients require closer follow-up and initiation of lifestyle modification. Additional studies are required to determine whether drug treatment should be initiated at an earlier stage.
Reference:
Kshirsagar AV et al. Blood pressure usually considered normal is associated with an elevated risk of cardiovascular disease. Am J Med 2006 Feb; 119:133-41.