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Prehypertension Is "On the Map" of Cardiovascular Risk Factors
DALLAS, TX -- February 20, 2007 -- According to researchers studying postmenopausal women in the Women's Health Initiative, prehypertension exists in about 40% of postmenopausal women and it is associated with a 58% higher risk of cardiovascular death, regardless of ethnicity, compared to normal blood pressure.
Using the most recent definitions for hypertension, normal blood pressure is systolic pressure (the top number in a blood pressure reading) less than 120 mm Hg and diastolic (bottom number) less than 80 mm Hg; prehypertension is systolic pressure of 120-139 or diastolic 80-89 mm Hg; and hypertension is systolic pressure of 140 mm Hg or higher, or diastolic pressure of 90 mm Hg or higher or currently taking antihypertensive medication.
"Is the cardiovascular risk with blood pressures slightly above 120/80 mm Hg clinically important enough to justify the label of prehypertension?" asked the study authors. "The increased cardiovascular risk with prehypertension is certainly smaller than the risk associated with having diabetes (158% higher risk), but is greater than that associated with smoking (34% higher). Since smoking is pretty much unchallenged as a cardiovascular risk factor, perhaps prehypertension should be afforded the same acceptance."
Researchers studied 60,785 postmenopausal women in the Women's Health Initiative during a 7.7-year follow-up. At the start of the study, 26% had normal blood pressure, 39% had prehypertension and 35% had hypertension. Prehypertension rates among women of different ethnic groups were 39.5% for whites, 32.1 for blacks, 42.6 for Hispanics, 38.7 for American Indians and 40.3% for Asians.
Women with higher blood pressures were more likely to be older, have higher body mass index, diabetes or high cholesterol. Smoking was more common among women with normal blood pressure (10%).
The 10-year incidence of cardiovascular events was 3.63% for women with normal blood pressure, 7.11% for women with prehypertension; and 14.16% for women with high blood pressure.
Compared to women with normal blood pressure, prehypertensive women of any ethnicity had a 58% higher risk of cardiovascular death: 76% higher risk of heart attack; 93% higher risk of stroke; 36% higher risk for being hospitalized with heart failure; and 66% higher risk for any cardiovascular event. Even after adjusting for age, body mass index, diabetes, high cholesterol and smoking status, prehypertension was independently associated with a higher risk of cardiovascular events.
Prehypertension and cardiovascular disease risk in the women's health initiative. From the women's focus issue of Circulation: Journal of the American Heart Association.
SOURCE: American Heart Association
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