Is prehypertension a risk factor for cardiovascular diseases?

• Published in: Stroke (1970) Vol. 36; no. 9; pp. 1859 - 1863
• Main Authors: QURESHI, Adnan I, SURI, M. Fareed K, KIRMANI, Jawad F, DIVANI, Afshin A, MOHAMMAD, Yousef
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 01-09-2005
• Subjects: Adult; Aged; Biological and medical sciences; Blood Pressure; Cardiology. Vascular system; Cardiovascular Diseases - etiology; Cardiovascular Diseases - pathology; Cohort Studies; Coronary Artery Disease - diagnosis; Coronary Artery Disease - pathology; Coronary heart disease; Disease-Free Survival; Female; Follow-Up Studies; Heart; Humans; Hypertension - diagnosis; Hypertension - pathology; Incidence; Male; Medical sciences; Middle Aged; Myocardial Infarction - diagnosis; Myocardial Infarction - pathology; Neurology; Proportional Hazards Models; Risk; Risk Factors; Smoking; Stroke - pathology; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the heart; Time Factors; Treatment Outcome; Vascular diseases and vascular malformations of the nervous system; Hypertension; Myocardial infarction; Stroke; Nervous system diseases; Cardiovascular disease; cardiovascular diseases; Myocardial disease; Cerebral disorder; Vascular disease; Heart disease; Central nervous system disease; Atherosclerosis; Risk factor; cerebrovascular disorders; Cerebrovascular disease
• ISSN: 0039-2499; 1524-4628
• DOI: 10.1161/01.str.0000177495.45580.f1

The Joint National Committee on High Blood Pressure identified a new category of blood pressure in adults termed prehypertension. Our objective was to determine the long-term risk of cardiovascular diseases associated with this new category in a well-defined cohort of adults.
We evaluated the association of prehypertension (120 to 139/80 to 89 mm Hg) and hypertension (>140/90 mm Hg) with the incidence of atherothrombotic brain infarction (ABI), all strokes, myocardial infarction (MI), and coronary artery disease (CAD) using pooled repeated measures and Cox proportional hazards analyses during follow-up after adjusting for age, gender, obesity, diabetes mellitus, hypercholesterolemia, cigarette smoking, and study period in a cohort of 5181 persons who participated in the Framingham Study.
Among the 11,116 person observations with a mean follow-up period of 9.9+/-1.0 years, prehypertension was not associated with an increased risk for ABI (relative risk [RR], 2.2; 95% CI, 0.5 to 9.3). Among the 11,802 person observations with a mean follow-up period of 9.7+/-1.5 years, prehypertension was associated with an increased risk for MI (RR, 3.5; 95% CI, 1.6 to 7.5). Prehypertension was also associated with an increased risk of CADs among the 11,570 person observations (RR, 1.7; 95% CI, 1.2 to 2.4).
Prehypertension appears to be associated with an increased risk of MI and CAD but not stroke. Further studies are required to confirm the anticipated benefits of identifying and intervening in persons with prehypertension.