Prehypertension in disease-free adults : a marker for an adverse cardiometabolic risk profile

• Published in: Hypertension research Vol. 33; no. 9; pp. 905 - 910
• Main Authors: Gupta, Alok K, McGlone, Meghan, Greenway, Frank L, Johnson, William D
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.09.2010
• Subjects: 692/53; 692/699/75/243; 692/700/139; 692/700/459; Adult; Aged; Biomarkers - blood; Blood Glucose - analysis; Blood Glucose - metabolism; Blood Pressure; BMI; Body Mass Index; C-Reactive Protein - analysis; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - metabolism; Cholesterol - blood; CRP; Female; Geriatrics/Gerontology; Glycated Hemoglobin A - analysis; Health Promotion and Disease Prevention; Humans; Insulin - blood; insulin resistance; Internal Medicine; Male; Medicine; Medicine & Public Health; metabolic syndrome; Middle Aged; Nutrition Surveys - statistics & numerical data; Obstetrics/Perinatology/Midwifery; original-article; Prehypertension - epidemiology; Prehypertension - metabolism; Prevalence; Public Health; Risk Factors; Sex Factors; Triglycerides - blood; United States - epidemiology; Waist Circumference; Young Adult; CRP; metabolic syndrome; waist circumference; insulin resistance; BMI
• ISSN: 0916-9636; 1348-4214; 1348-4214
• DOI: 10.1038/hr.2010.91

Cardiovascular disease (CVD) is the leading cause of death worldwide. Understandably, cardiometabolic risk assessment is an integral component of every adult health evaluation. Customary assessment measures are, however, inadequate: as two-thirds of sudden cardiac deaths occur in clinically healthy individuals. Novel indicators favoring early recognition of adverse cardiometabolic risk in disease-free adults are clearly needed. Clinically healthy disease-free adults with prehypertension (PreHTN: BP120–139/80–89 mm Hg) have an adverse cardiometabolic risk profile. A statistical analysis of disease-free adult NHANES participants was conducted from 1999 to 2006. Overall prevalence of PreHTN in disease-free adults was 36.3%. Prevalence was higher in men ( P <0.001) increasing with age up to 70 years ( P <0.001). Prevalence correlated strongly with indicators of adverse cardiometabolic risk profile: it was higher with increasing body mass index (BMI) and waist circumference (WC) ( P <0.001 for both). Means were significantly higher for BMI, WC, glucose, insulin, hemoglobin A1c, homeostasis model assessment, pulse pressure, C-reactive protein, total cholesterol and triglycerides in subjects with PreHTN ( vs. desirable BP: P <0.05 for all). Prevalence of two or more unfavorable risk factors (other than high BP) was 30% higher in disease-free adults with PreHTN vs. desirable BP (prevalence ratio: 1.30; 95% CI: 1.22, 1.39). Detection of PreHTN (a precursor for subsequent HTN), during annual health maintenance in disease-free adults, (especially with one or more of the recognized CVD risk correlates), could become an early marker of adverse cardiometabolic risk profile. Clinical care designed to prevent progression from PreHTN to HTN (JNC 7 recommendation) may attenuate risk.