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Hypertension, Vol 17, 22-27, Copyright © 1991 by American Heart Association
M Leitschuh, LA Cupples, W Kannel, D Gagnon and A Chobanian
This study sought to determine if individuals with high-normal blood
pressure (diastolic blood pressure of 85-89 mm Hg) progress to hypertension
more frequently than those with normal blood pressure (diastolic blood
pressure less than 85 mm Hg), thus advancing to a higher cardiovascular
risk category. Individuals from the Framingham Heart Study were placed in
normal and high-normal blood pressure categories and followed for 26 years
for the development of hypertension. With hypertension defined as a
diastolic blood pressure of 95 mm Hg or greater or the initiation of
antihypertensive therapy, 23.6% of men and 36.2% of women with normal blood
pressure developed hypertension compared with 54.2% of men and 60.6% of
women with high- normal blood pressure. The relative risk for the
development of hypertension associated with high-normal blood pressure was
2.25 for men (95% confidence interval [CI], 1.8-2.8; p less than 0.0001)
and 1.89 for women (95% CI, 1.5-2.3; p less than 0.0001). The age-adjusted
relative risks estimated by the proportional hazards model were 3.36 for
men and 3.37 for women (p less than 0.001). Among those risk factors
examined, baseline systolic and diastolic blood pressure, Metropolitan
relative weight, and change in weight over time were significant predictors
of future hypertension in men and women whose initial blood pressure was
normal. For men with high-normal blood pressure, systolic blood pressure
and change in weight were identified as risk factors for future
hypertension. These results indicate that the probability of individuals
with blood pressure in the high-normal range developing hypertension is
twofold to threefold higher than in those with normal blood
pressure.(ABSTRACT TRUNCATED AT 250 WORDS)
ARTICLES
High-normal blood pressure progression to hypertension in the Framingham Heart Study
Evans Department of Clinical Research, Boston University School of Medicine, Mass.
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