High-normal Blood Pressure: A Blood Pressure Stage Needs Serious Attention_West China Medical Journal

Authors：

 ZHONGGui-you , WANGYong , HESen , WANShi-xi , PANPei , ZHOUYu-fei , WENBo ,  CHENXiao-ping

Department of Cardiology, West China Hospital, Sichuan University, Chengdu Sichuan 610041, P. R. China;

Corresponding author：

CHENXiao-ping, Email: chenxp2@yahoo.cn

Keywords：

High-normal blood pressure; Hypertension; Cardiovascular risk factor

DOI：

10.7507/1002-0179.20140001

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To investigate the significance of using the term "high-normal blood pressure" and its intervention in the early stage. Methods In 1992 and 2007, we performed two similar investigations focusing on cardiovascular risk factors in 711 people in Chengdu city. Since 114 individuals were diagnosed with hypertension, 597 people without hypertension were eligible and divided into two groups:the normal-pressure[<120/80 mm Hg (1 mm Hg=0.133 kPa)] group and the high-normal blood pressure (systolic blood pressure 120-139 mm Hg and/or diastolic blood pressure 80-89 mm Hg) group. Data in the two investigations were compared to explore the relationship among high-normal blood pressure, cardiovascular disease (CVD) and hypertension. Results The high-normal blood pressure group had a higher level of CVD risk factors both in 1992 and 2007, and the 15-year cumulative incidence of hypertension in the high-normal blood pressure group was higher than that of normal-pressure group (91.2% vs. 22.2%, P<0.001). After adjusting for serum lipid, body weight and other CVD risk factors, high-normal blood pressure could predict the progression into hypertension[HR=5.354, 95% CI (4.094, 7.002), P=0.001]. There was no statistics difference in CVD prevalence in the two groups in 1992, but in 2007 the prevalence of CVD tended to be higher in the high-normal blood pressure group (6.6% vs. 3.1%, P=0.052). Conclusion High-normal blood pressure is a special stage of blood pressure with high level of CVD risk factors and high potential to progress into hypertension. The term should be emphasized and intervention should be done in the early stage for high-normal blood pressure people to prevent from hypertension and CVD.

Citation： ZHONGGui-you, WANGYong, HESen, WANShi-xi, PANPei, ZHOUYu-fei, WENBo, CHENXiao-ping. High-normal Blood Pressure: A Blood Pressure Stage Needs Serious Attention. West China Medical Journal, 2014, 29(1): 1-4. doi: 10.7507/1002-0179.20140001 Copy

1.	Chobanian AV, Bakris GL, Black HR, et al. The seventh report of the joint national. Committee on prevention, detection, evaluation, and treatment of high blood pressure:the JNC 7 report[J]. JAMA, 2003, 289(19):2560-2572.
2.	National Institute for Health and Clinical Excellence. Hypertension:the clinical management of primary hypertension in adults[EB/OL]. (2011-08-13)[2012-05-05]. http://www.nice.org.uk/nicemedia/live/13561/56008/56008.pdf.
3.	中国高血压防治指南修订委员会.中国高血压防治指南2010[J].中华心血管病杂志, 2011, 39(7):579-616.
4.	林金秀, 谢私.正常高值血压的治疗观点[J].中华高血压杂志, 2007, 15(增刊):8-10.
5.	Ren J, Grundy SM, Liu J, et al. Long-term coronary heart disease risk associated with very-low-density lipoprotein cholesterol in Chinese:the results of a 15-year Chinese Multi-Provincial Cohort Study (CMCS)[J]. Atherosclerosis, 2010, 211(1):327-332.
6.	He S, Wang S, Chen X, et al. Higher ratio of triglyceride to high-density lipoprotein cholesterol may predispose to diabetes mellitus:15-year prospective study in a general population[J]. Metabolism, 2012, 61(1):30-36.
7.	刘冰, 李卫, 胡泊,等.中国35-40岁人群正常高值血压检出率及影响因素分析[J].中华高血压杂志, 2010, 18(2):187-192.
8.	Mainous AG, Everett CJ, Liszka H, et al. Prehypertension and mortality in a nationally representative cohort[J]. Am J Cardiol, 2004, 94(12):1496-1500.
9.	吴寿岭, 张子强, 宋胜斌.正常高值血压人群转归及其影响因素[J].中华心血管病杂志, 2010, 38(5):415-419.
10.	Grotto I, Grossman E, Huerta M, et al. Prevalence of prehypertension and associated cardiovascular risk profiles among young Israeli adults[J]. Hypertension, 2006, 48(2):254-259.
11.	Vasan RS, Larson MG, Leip EP, et al. Assessment of frequency of progression to hypertension in non-hypertensive participants in the Framingham Heart Study:a cohort study[J]. Lancet, 2001, 358(9294):1682-1686.
12.	He S, Chen X. Prehypertension should be considered a special blood pressure phase[J]. Hypertens Res, 2012, 35(5):561-562.
13.	Wu S, Huang Z, Yang X, et al. Cardiovascular events in a prehypertensive Chinese population:four-year follow-up study[J].Int J Cardiol, 2013, 167(5):2196-2199.
14.	吴寿岭,钟吉文,王丽晔,等.正常高值血压人群中心脑血管事件发生情况及影响因素[J].中华高血压杂志, 2012, 20(3):247-251.
15.	Angela M, Tian Hu, Carrie L, et al. Antihypertensive treatment and secondary prevention of cardiovascular disease events among persons without hypertension:a Meta-analysis[J]. JAMA, 2011, 305(9):913-922.
16.	Lüders S, Schrader J, Berger J, et al. The PHARAO study:prevention of hypertension with the angiotensinconverting enzyme inhibitor ramipril in patients with high-normal blood pressure:a prospective, randomized, controlled prevention trial of the German Hypertension League[J]. J Hypertens, 2008, 26(7):1487-1496.
17.	Julius S, Nesbitt SD, Egan BM, et al. Feasibility of treating prehypertension with an angiotensin-receptor blocker[J]. N Engl J Med, 2006, 354(16):1685-1697.

1. Chobanian AV, Bakris GL, Black HR, et al. The seventh report of the joint national. Committee on prevention, detection, evaluation, and treatment of high blood pressure:the JNC 7 report[J]. JAMA, 2003, 289(19):2560-2572.
2. National Institute for Health and Clinical Excellence. Hypertension:the clinical management of primary hypertension in adults[EB/OL]. (2011-08-13)[2012-05-05]. http://www.nice.org.uk/nicemedia/live/13561/56008/56008.pdf.
3. 中国高血压防治指南修订委员会.中国高血压防治指南2010[J].中华心血管病杂志, 2011, 39(7):579-616.
4. 林金秀, 谢私.正常高值血压的治疗观点[J].中华高血压杂志, 2007, 15(增刊):8-10.
5. Ren J, Grundy SM, Liu J, et al. Long-term coronary heart disease risk associated with very-low-density lipoprotein cholesterol in Chinese:the results of a 15-year Chinese Multi-Provincial Cohort Study (CMCS)[J]. Atherosclerosis, 2010, 211(1):327-332.
6. He S, Wang S, Chen X, et al. Higher ratio of triglyceride to high-density lipoprotein cholesterol may predispose to diabetes mellitus:15-year prospective study in a general population[J]. Metabolism, 2012, 61(1):30-36.
7. 刘冰, 李卫, 胡泊,等.中国35-40岁人群正常高值血压检出率及影响因素分析[J].中华高血压杂志, 2010, 18(2):187-192.
8. Mainous AG, Everett CJ, Liszka H, et al. Prehypertension and mortality in a nationally representative cohort[J]. Am J Cardiol, 2004, 94(12):1496-1500.
9. 吴寿岭, 张子强, 宋胜斌.正常高值血压人群转归及其影响因素[J].中华心血管病杂志, 2010, 38(5):415-419.
10. Grotto I, Grossman E, Huerta M, et al. Prevalence of prehypertension and associated cardiovascular risk profiles among young Israeli adults[J]. Hypertension, 2006, 48(2):254-259.
11. Vasan RS, Larson MG, Leip EP, et al. Assessment of frequency of progression to hypertension in non-hypertensive participants in the Framingham Heart Study:a cohort study[J]. Lancet, 2001, 358(9294):1682-1686.
12. He S, Chen X. Prehypertension should be considered a special blood pressure phase[J]. Hypertens Res, 2012, 35(5):561-562.
13. Wu S, Huang Z, Yang X, et al. Cardiovascular events in a prehypertensive Chinese population:four-year follow-up study[J].Int J Cardiol, 2013, 167(5):2196-2199.
14. 吴寿岭,钟吉文,王丽晔,等.正常高值血压人群中心脑血管事件发生情况及影响因素[J].中华高血压杂志, 2012, 20(3):247-251.
15. Angela M, Tian Hu, Carrie L, et al. Antihypertensive treatment and secondary prevention of cardiovascular disease events among persons without hypertension:a Meta-analysis[J]. JAMA, 2011, 305(9):913-922.
16. Lüders S, Schrader J, Berger J, et al. The PHARAO study:prevention of hypertension with the angiotensinconverting enzyme inhibitor ramipril in patients with high-normal blood pressure:a prospective, randomized, controlled prevention trial of the German Hypertension League[J]. J Hypertens, 2008, 26(7):1487-1496.
17. Julius S, Nesbitt SD, Egan BM, et al. Feasibility of treating prehypertension with an angiotensin-receptor blocker[J]. N Engl J Med, 2006, 354(16):1685-1697.

Next Article
妇科白带盐水法和快速染色法的比较分析

West China Medical Journal

High-normal Blood Pressure: A Blood Pressure Stage Needs Serious Attention

Abstract Full text Figures/Tables Video References Cited by

Next Article

Format

Content