Impact of High-Normal Blood Pressure on the Risk of Cardiovascular Disease

• Published in: The New England journal of medicine Vol. 345; no. 18; pp. 1291 - 1297
• Main Authors: Vasan, Ramachandran S, Larson, Martin G, Leip, Eric P, Evans, Jane C, O'Donnell, Christopher J, Kannel, William B, Levy, Daniel
• Format: Journal Article
• Language: English
• Published: Boston, MA Massachusetts Medical Society 01-11-2001
• Subjects: Adult; Aged; Aged, 80 and over; Arterial hypertension. Arterial hypotension; Biological and medical sciences; Blood and lymphatic vessels; Blood Pressure; Cardiology. Vascular system; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - etiology; Clinical manifestations. Epidemiology. Investigative techniques. Etiology; Female; Follow-Up Studies; Humans; Hypertension - complications; Incidence; Male; Medical sciences; Middle Aged; Proportional Hazards Models; Reference Values; Risk Factors; Human; Hypertension; Cardiovascular disease; Risk factor; Sex
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJMoa003417

Although frank hypertension is clearly associated with an increased risk of cardiovascular events, the implications of high-normal blood pressure are less clear. This prospective analysis from the Framingham Study demonstrates that the relative risk of cardiovascular events is significantly higher among both men and women with high-normal blood pressure than among those with optimal blood pressure.
This prospective analysis from the Framingham Study demonstrates that the risk of cardiovascular events is significantly higher with high-normal blood pressure than with optimal blood pressure.
Several epidemiologic studies
1
–
7
have demonstrated that systolic and diastolic blood pressures have a “strong, continuous, graded and etiologically significant” positive association with cardiovascular-disease outcomes.
1
These relations are consistent in both men and women, in young, middle-aged, and older subjects, among different racial and ethnic groups,
1
–
5
and within and between countries.
6
,
7
Although there is a continuum of cardiovascular risk across levels of blood pressure,
1
–
7
the classification of adults according to blood pressure provides a framework for differentiating levels of risk associated with various blood-pressure categories and for defining treatment thresholds and therapeutic goals.
According to the classification . . .