Abstract 85: Pre-Hypertension is a Disease Associated with Significant Structural and Functional Cardiovascular Abnormalities. It is Time to Lower the Bar.
Purpose: To examine whether pre-HTN is a risk factor for CV structural and functional abnormalities.
METHODS: We screened 2233 asymptomatic subjects, age 23-80, for CVD risk using Early CVD Risk Score (ECVDRS). ECVDRS consists of 10 tests: large (C1) and small (C2) artery stiffness, BP at rest and post mild exercise (PME), Carotid Intima Media Thickness (CIMT), abdominal aorta and left ventricle ultrasound, retinal photography, microalbuminuria, ECG, and pro-BNP. Pre-HTN and normotension (NT) was defined according to the JNC VII criteria.
Results: Among the subjects screened, 38% (855 of 2233) were NT; 70% (596 of 855) were not taking CV medication. 42% (942 of 2233) of subjects were pre-HTN; 55% (521 of 942) were not taking CV medication. The untreated, NT group was split into Group A 82% (491 of 596) with norm. BP rise PME and Group B 18% (105 of 596) with abn. BP rise PME. The untreated, pre-HTN group was split into Group C 61% (318 of 521) with norm. BP rise PME and Group D 39% (203 of 521) with abn. BP rise PME. The presence of structural abnormalities in the groups is shown on Table 1.
Conclusions: Based on our data, pre-HTN is a prevalent disease (42%), exceeding NT (38%) in the subjects screened. Pre-HTN is associated with greater functional and structural abnormalities than the NT group. The structural abnormalities, particularly CIMT (statistically significant p value of <0.0016), may be accounted for by the greater abn. BP rise PME in the pre-HTN group (39%). Based on our data, pre-HTN justifies ECVDRS screening for appropriate risk stratification and treatment. These findings may warrant lowering the bar for the definitions of HTN and pre-HTN in future guidelines.
- © 2012 by American Heart Association, Inc.