Association of Central Blood Pressure and Carotid Intima Media Thickness with New-Onset Hypertension in People with High Normal Blood Pressure

• Published in: Journal of Atherosclerosis and Thrombosis Vol. 30; no. 12; pp. 1905 - 1916
• Main Authors: Tokioka, Sayuri, Nakaya, Naoki, Nakaya, Kumi, Takase, Masato, Kogure, Mana, Hatanaka, Rieko, Chiba, Ippei, Kanno, Ikumi, Nochioka, Kotaro, Metoki, Hirohito, Murakami, Takahisa, Satoh, Michihiro, Nakamura, Tomohiro, Obara, Taku, Hamanaka, Yohei, Kobayashi, Tomoko, Uruno, Akira, Sugawara, Junichi, Kodama, Eiichi N, Ogishima, Soichi, Izumi, Yoko, Fuse, Nobuo, Kuriyama, Shinichi, Tsuji, Ichiro, Hozawa, Atsushi
• Format: Journal Article
• Language: English
• Published: Japan Japan Atherosclerosis Society 01-12-2023
• Subjects: Blood Pressure - physiology; Carotid Intima-Media Thickness; Central blood pressure; Cohort Studies; Female; Hemodynamic indices; Humans; Hypertension; Hypertension - complications; Intima media thickness; Middle Aged; Prospective Studies; Risk Factors; Hypertension; Central blood pressure; Hemodynamic indices; Intima media thickness
• ISSN: 1340-3478; 1880-3873
• DOI: 10.5551/jat.64151

Aim: People with high normal blood pressure (BP) have a higher risk of cardiovascular events than those with normal BP; therefore, progression to hypertension (HT) should be prevented. We aimed to assess the HT risk using central BP and carotid intima media thickness (CIMT) in people with high normal BP. Methods: This prospective cohort study used the Tohoku Medical Megabank Community-Based Project Cohort Study (conducted from 2013 in Miyagi Prefecture in Japan). The participants had a high normal BP, defined as a systolic BP of 120–139 mmHg and diastolic BP ＜90 mmHg using brachial BP measurement during the baseline survey. The outcome was new-onset HT during the secondary survey, conducted four years after the baseline survey. Results: Overall, 4,021 participants with high normal BP during the baseline survey, with an average age of 58.7 years, were included; 1,030 (26%) were diagnosed with new-onset HT during the secondary survey, 3.5±0.7 years after the baseline survey. The multivariable odds ratio (95% confidence interval) for HT in the highest versus lowest quartile of central BP was 1.7 (1.2–2.4, p=0.0030), and that of CIMT was 1.8 (1.4–2.4, p＜0.001). Subgroup analysis according to age (＜60 and ≥ 60 years) and sex revealed that the central BP was influential in groups with younger age and female individuals; CIMT was influential in all groups. Conclusions: Higher central BP and thicker CIMT at the baseline were correlated with new-onset HT in individuals with high normal BP, independent of brachial systolic BP and other cardiovascular risk factors.