Hypertension, Vol 20, 38-45, Copyright © 1992 by American Heart Association
SM Haffner, E Ferrannini, HP Hazuda and MP Stern
Numerous studies have indicated that hypertensive subjects have an
atherogenic lipoprotein pattern, hyperinsulinemia, and impaired glucose
tolerance relative to normotensive individuals. These abnormalities could
be due to adverse effects of certain antihypertensive agents, to
pathophysiological concomitants of the hypertensive state itself, or to
both. In this report, we describe the cardiovascular risk factor profile of
1,440 subjects who were normotensive and were not taking any
antihypertensive medications when first examined and who subsequently
participated in the 8-year follow-up of the San Antonio Heart Study.
Hypertension developed in 130 subjects during the follow-up period. At
baseline these prehypertensive individuals had significantly higher levels
of blood pressure, fasting total and low density lipoprotein cholesterol,
triglyceride, glucose, and insulin, and 2-hour glucose than those who
remained free of hypertension. In addition, they had higher body mass
indexes, a less favorable body fat distribution, and lower levels of high
density lipoprotein cholesterol. In multiple linear regression analyses,
baseline levels of triglyceride and blood pressure remained significantly
higher and high density lipoprotein cholesterol remained significantly
lower in the subjects who later converted to hypertension than in those who
remained normotensive. Although baseline insulin levels were also higher in
the prehypertensive subjects, this difference was not statistically
significant. In nonobese subjects, however, those with high baseline
insulin concentrations had an increased incidence of hypertension compared
with those with low insulin concentrations. The present results suggest
that the cluster of atherogenic changes associated with hypertension
actually precede the development of the hypertensive state.
ARTICLES
Clustering of cardiovascular risk factors in confirmed prehypertensive individuals
Department of Medicine, University of Texas Health Science Center, San Antonio 78284-7873.
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