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Incidence and risk factors for progression from prehypertension to hypertension: a 12-year Korean Cohort Study. J Hypertens 2021; 38:1755-1762. [PMID: 32398468 DOI: 10.1097/hjh.0000000000002494] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVES This study evaluated the incidence and risk factors for progression from prehypertension to hypertension among middle-aged and elderly Korean adults. METHODS A total of 115 456 participants with prehypertension in 2003-2004 were selected from the National Health Insurance Service-National Health Screening Cohort (NHIS-HEALS) Program. All participants were followed until 2015. Potential risk factors for progression to hypertension were evaluated using the chi-squared test or t-test. A Cox proportional hazards model was used to predict the risk of progression to hypertension according to sex. The incidence of hypertension in the prehypertension group was evaluated by calculating the incidence density during the entire follow-up period. RESULTS During the follow-up period, 48 919 participants experienced progression to hypertension, which corresponded to incidence densities of 45.82/1000 person-years among men and 53.57/1000 person-years among women. Among both men and women, progression to hypertension was predicted by an elevated BMI, family history of hypertension, history of diabetes mellitus, and older age. Among men, progression to hypertension was associated with frequent drinking and high alanine aminotransferase levels. Among women, progression to hypertension was associated with high hemoglobin levels and low household income. CONCLUSION This study identified various risk factors for progression from prehypertension to hypertension among middle-aged and elderly Korean adults. This information may help researchers develop comprehensive and effective strategies for managing prehypertension.
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Lydia A, Setiati S, Soejono CH, Istanti R, Marsigit J, Azwar MK. Prevalence of prehypertension and its risk factors in midlife and late life: Indonesian family life survey 2014-2015. BMC Public Health 2021; 21:493. [PMID: 33711980 PMCID: PMC7953817 DOI: 10.1186/s12889-021-10544-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 03/03/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Early detection of prehypertension is important to prevent hypertension-related complications, such as cardiovascular disease, cerebrovascular disease and all-cause mortality. Data regarding the prevalence of prehypertension among mid- and late-life population in Indonesia were lacking. It is crucial to obtain the prevalence data and identify the risk factors for prehypertension in Indonesia, which may differ from that of other countries. METHODS The cross-sectional analysis utilized multicenter data from Indonesian Family Life Survey-5 (IFLS-5) from 13 provinces in 2014-2015. We included all subjects at mid-and late-life (aged ≥40 years old) from IFLS-5 with complete blood pressure data and excluded those with prior diagnosis of hypertension. Prehypertension was defined as high-normal blood pressure according to International Society of Hypertension (ISH) 2020 guideline (systolic 130-139 mmHg and/or diastolic 85-89 mmHg). Sociodemographic factors, chronic medical conditions, physical activity, waist circumference and nutritional status were taken into account. Statistical analyses included bivariate and multivariate analyses. RESULTS There were 5874 subjects included. The prevalence of prehypertension among Indonesian adults aged > 40 years old was 32.5%. Age ≥ 60 years (adjusted OR 1.68, 95% CI 1.41-2.01, p < 0.001), male sex (adjusted OR 1.65, 95% CI 1.45-1.88, p < 0.001), overweight (adjusted OR 1.44, 95% CI 1.22-1.70, p < 0.001), obesity (adjusted OR 1.77, 95% CI 1.48-2.12, p < 0.001), and raised waist circumference (adjusted OR 1.32, 95% CI 1.11-1.56, p = 0.002) were the significant risk factors associated with prehypertension. Prehypertension was inversely associated with being underweight (adjusted OR 0.74, 95% CI 0.59-0.93, p = 0.009). CONCLUSIONS The prevalence of prehypertension in Indonesian mid- and late-life populations is 32.5%. Age ≥ 60 years, male sex, overweight, obesity, and raised waist circumference are risk factors for prehypertension.
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Affiliation(s)
- Aida Lydia
- Department of Internal Medicine, Division of Nephrology and Hypertension, Cipto Mangunkusumo Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Siti Setiati
- Clinical Epidemiology and Evidence-Based Medicine, Cipto Mangunkusumo Hospital, Jakarta, Indonesia. .,Department of Internal Medicine, Division of Geriatric Medicine, Cipto Mangunkusumo Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia.
| | - Czeresna Heriawan Soejono
- Department of Internal Medicine, Division of Geriatric Medicine, Cipto Mangunkusumo Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Rahmi Istanti
- Department of Internal Medicine, Division of Geriatric Medicine, Cipto Mangunkusumo Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
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Gupta V, LoGerfo JP, Raingsey PP, Fitzpatrick AL. The prevalence and associated factors for prehypertension and hypertension in Cambodia. HEART ASIA 2013; 5:253-8. [PMID: 27326148 DOI: 10.1136/heartasia-2013-010394] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Revised: 10/18/2013] [Accepted: 11/23/2013] [Indexed: 11/04/2022]
Abstract
BACKGROUND Hypertension is strongly associated with adverse cardiovascular outcomes and was the leading modifiable associated factor for global disease burden in 2010. Analysis of modifiable associated factors will be important to those concerned with mitigating the adverse effects of hypertension. We studied factors associated with hypertension in adults aged 25-64 years of age in Cambodia in order to help develop strategies for planned new initiatives for prevention and control of hypertension. METHODS Using data from a nationwide survey in Cambodia assessing the prevalence of associated factors for non-communicable disease in 2010 (WHO STEPs survey), 5017 participants between the ages of 25 and 64 years were included in a secondary analysis of the prevalence and predictors of hypertension. RESULTS The prevalence of prehypertension in this sample was approximately double that of overall hypertension (27.9% vs 15.3%). Male sex, increasing age and known cardiovascular associated factors, including higher Body Mass Index (BMI), dyslipidaemia, impaired fasting glycaemia, and abdominal obesity were all associated with an increased prevalence of hypertension. In multivariate models, increasing age was the strongest associated factor for hypertension (OR 8.79, 95% CI (5.43 to 14.2)), whereas, higher BMI was the primary associated factor associated with prehypertension (OR 3.27, 95% CI 2.21 to 4.82). CONCLUSIONS Modifiable cardiovascular-associated factors are strongly correlated with prehypertension and hypertension in Cambodia, and may be a focus of public health and primary care strategies to mitigate subsequent ischaemic heart disease and stroke. A national strategy aimed at increased screening and adherence to medical therapy is a necessary first step to reduce burden of disease and related morbidities.
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Affiliation(s)
- Vinay Gupta
- Departments of Internal Medicine and Global Health , University of Washington Medical Center , Seattle, Washington , USA
| | - James P LoGerfo
- Departments of Internal Medicine and Global Health , University of Washington Medical Center , Seattle, Washington , USA
| | | | - Annette L Fitzpatrick
- Departments of Epidemiology and Global Health , University of Washington School of Public Health , Seattle, Washington , USA
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Bozorgmanesh M, Ghoreishian H, Mohebi R, Azizi F, Hadaegh F. Sex-specific predictors of the prehypertension-to-hypertension progression: community-based cohort of a West-Asian population. Eur J Prev Cardiol 2013; 21:956-63. [PMID: 23478742 DOI: 10.1177/2047487313481757] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2012] [Accepted: 02/18/2013] [Indexed: 01/11/2023]
Abstract
BACKGROUND We aimed to predict prehypertension-to-hypertension progression rate among a West-Asian adult population. METHODS We analyzed data on 3449 adults (mean age 41.0 years), prehypertensive at baseline, attending at least one follow-up visit, contributing 25,079 person-years follow-up. A proportional hazard regression analysis was implemented to model the interval-censored progression-free survival time data using readily-assessable, commonly-available information. Integrated discriminatory improvement (IDI) and net reclassification improvement (NRI) indices were calculated to examine whether simple clinical information could help improve prediction of prehypertension-to-hypertension progression rate based on the blood pressure measures. RESULTS During a median seven-year follow-up 1412 prehypertensive patients progressed to hypertension with annual progression rate (95% confidence intervals (CIs)) being 56.9 (52.9-61.2) per 1000 women and 55.7 (51.7-60.0) per 1000 men (p = 0.007). High-density lipoprotein cholesterol levels were inversely associated with prehypertension-to-hypertension progression rate only among women (hazard ratio (1-SD): 0.93, 95% CIs: 0.86-0.100). Marital status retained its predictability among women even after multivariate adjustments. In both men and women, age, blood pressure measures, waist-to-height ratio, fasting plasma glucose and a history of cardiovascular disease independently predicted prehypertension-to-hypertension rate. The absolute (0.114, 95% CIs: 0.107-0.120) and relative (2.638, 95% CIs: 2.374-2.903) IDI and cutpoint-based (0.213, 95% CIs: 0.156-0.269) and cutpoint-free NRI (0.523, 95% CIs: 0.455-0.591) indicated that the prediction of the prehypertension-to-hypertension progression was improved by multivariable-models compared with blood pressure measures alone. DISCUSSION Easily-assessable, commonly-available information helped improve predictability of blood pressure measures for prehypertension-to-hypertension progression. Women's psycho-social characteristics (marital status) should be considered in prevention of prehypertension-to-hypertension progression.
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Affiliation(s)
- Mohammadreza Bozorgmanesh
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hadi Ghoreishian
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Reza Mohebi
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzad Hadaegh
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Rahmanian K, Shojaie M. The prevalence of pre-hypertension and its association to established cardiovascular risk factors in south of Iran. BMC Res Notes 2012; 5:386. [PMID: 22838639 PMCID: PMC3506467 DOI: 10.1186/1756-0500-5-386] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2012] [Accepted: 06/18/2012] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Pre-hypertension is associated with an increased risk of the development of hypertension and subsequent cardiovascular disease and raises mortality risk. The aim of this study was to determine the prevalence of pre-hypertension and to explore the associations between pre-hypertension and established cardiovascular risk factors in a population-based sample of Iranian adults. METHODS In this cross-sectional study a representative sample of 892 participants aged ≥ 30 years was selected using a multistage cluster sampling method. After completion of a detailed demographic and medical questionnaire (gender, age, history of diabetes mellitus and hypertension, taking antihypertensive or hypoglycemic agents and history of smoking), all participants were subjected to physical examination, blood lipid profile, blood glucose, anthropometric and smoking assessments, during the years 2009 and 2010. Variables were considered significant at a p-value ≤ 0.05. Statistical analysis was performed using SPSS version 11.5 software. RESULTS Pre-hypertension was observed among 300 (33.7%) subjects, 36.4% for men and 31.4% for women (p > 0.05). The pre-hypertensive group had higher levels of blood glucose and triglycerides, higher body mass index and lower percentage of smoking than did the normotensive group. Multivariate logistic regression analysis showed that obesity and overweight were the strongest predictors of pre-hypertension [odds ratio, 2.74: 95% CI (Confidence Interval), 1.62 to 4.62 p < 0.001; odds ratio, 2.56, 95% CI, 1.74 to 3.77, p < 0.001 respectively]. CONCLUSIONS Overweight and obesity are major determinants of the high prevalence rate of pre-hypertension detected in Iranian population. Therefore, primary prevention strategies should concentrate on reducing overweight and obesity if the increased prevalence of pre-hypertension is to be diminished in Iranian adults.
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Prehypertension among adults in Great Tunis region (Tunisia): A population-based study. ACTA ACUST UNITED AC 2012; 60:174-9. [DOI: 10.1016/j.patbio.2011.03.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2010] [Accepted: 03/31/2011] [Indexed: 11/19/2022]
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He S, Chen X. Prehypertension should be considered a special blood pressure phase. Hypertens Res 2012; 35:561-2. [DOI: 10.1038/hr.2012.31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Meng XJ, Dong GH, Wang D, Liu MM, Liu YQ, Zhao Y, Deng WW, Tian S, Meng X, Zhang HY. Epidemiology of Prehypertension and Associated Risk Factors in Urban Adults From 33 Communities in China. Circ J 2012; 76:900-6. [PMID: 22293448 DOI: 10.1253/circj.cj-11-1118] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Xiu-Jun Meng
- Division of Neurology, Fourth Affiliated Hospital of China Medical University
| | - Guang-Hui Dong
- Department of Biostatistics and Epidemiology, School of Public Health, China Medical University
| | - Da Wang
- Department of Biostatistics and Epidemiology, School of Public Health, China Medical University
| | - Miao-Miao Liu
- Department of Biostatistics and Epidemiology, School of Public Health, China Medical University
| | - Yu-Qin Liu
- Department of Biostatistics and Epidemiology, School of Public Health, China Medical University
| | - Yang Zhao
- Department of Biostatistics and Epidemiology, School of Public Health, China Medical University
| | - Wei-Wei Deng
- Department of Geriatrics, First Affiliated Hospital of China Medical University
| | - Shen Tian
- Division of Neurology, Fourth Affiliated Hospital of China Medical University
| | - Xin Meng
- Department of Geriatrics, First Affiliated Hospital of China Medical University
| | - Hai-Yan Zhang
- Department of Geriatrics, First Affiliated Hospital of China Medical University
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Hendricks EJ, Greenway FL, Westman EC, Gupta AK. Blood pressure and heart rate effects, weight loss and maintenance during long-term phentermine pharmacotherapy for obesity. Obesity (Silver Spring) 2011; 19:2351-60. [PMID: 21527891 DOI: 10.1038/oby.2011.94] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
There is a perception that phentermine pharmacotherapy for obesity increases blood pressure and heart rate (HR), exposing treated patients to increased cardiovascular risk. We collected data from phentermine-treated (PT) and phentermine-untreated (P0) patients at a private weight management practice, to examine blood pressure, HR, and weight changes. Records of 300 sequential returning patients were selected who had been treated with a low-carbohydrate ketogenic diet if their records included complete weight, blood pressure, and HR data from seven office examinations during the first 12 weeks of therapy. The mean time in therapy, time range, and mode was 92 (97.0), 12-624, and 52 weeks. 14% were normotensive, 52% were prehypertensive, and 34% were hypertensive at their first visit or had a previous diagnosis of hypertension. PT subjects systolic blood pressure/diastolic blood pressure (SBP/DBP) declined from baseline at all data points (SBP/DBP -6.9/-5.0 mm Hg at 26, and -7.3/-5.4 at 52 weeks). P0 subjects' declines of SBP/DBP at both 26 and 52 weeks were -8.9/-6.3 but the difference from the treated cohort was not significant. HR changes in treated/untreated subjects at weeks 26 (-0.9/-3.5) and 52 (+1.2/-3.6) were not significant. Weight loss was significantly greater in the PT cohort for week 1 through 104 (P = 0.0144). These data suggest phentermine treatment for obesity does not result in increased SBP, DBP, or HR, and that weight loss assisted with phentermine treatment is associated with favorable shifts in categorical blood pressure and retardation of progression to hypertension in obese patients.
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Affiliation(s)
- Ed J Hendricks
- The Center for Weight Management, Roseville, California, USA.
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Zhang WH, Zhang L, An WF, Ma JL. Prehypertension and clustering of cardiovascular risk factors among adults in suburban Beijing, China. J Epidemiol 2011; 21:440-6. [PMID: 21946627 PMCID: PMC3899460 DOI: 10.2188/jea.je20110022] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Background Prehypertension is common in China and is associated with an increased risk of cardiovascular disease. The present study estimated the current prevalence of prehypertension and its association with clustering of other modifiable cardiovascular risk factors (CRFs) among adults in suburban Beijing. Methods A cross-sectional survey of a representative sample of 19 003 suburban adults aged 18 to 76 years was carried out in 2007. Questionnaire data and information on blood pressure, anthropometric characteristics, and laboratory measurements were collected. Results The age-standardized prevalence of prehypertension was 35.7% (38.2% in men and 31.8% in women) among adults in suburban Beijing. The prevalence of overweight/obesity, diabetes, dyslipidemia, and physical inactivity was higher in participants with prehypertension (26.7%, 4.8%, 34.3%, and 60.4%, respectively) as compared with normotensive participants (15.9%, 2.7%, 20.5%, and 29.1%, respectively), and in participants with hypertension as compared with those with prehypertension. Overall, 85.3%, 49.8%, and 17.8% of prehypertensive men had 1 or more, 2 or more, and 3 or more CRFs (overweight/obesity, diabetes, dyslipidemia, current smoking, and physical inactivity). These proportions were higher than those in normotensive men (81.5%, 45.1%, and 13.4%) and lower than those in men with hypertension (91.7%, 56.4%, 19.2%). Similar results were found when women with prehypertension were compared with women who were normotensive or hypertensive. Conclusions A high prevalence of prehypertension and clustering of other modifiable CRFs are common among prehypertensive adults in suburban Beijing. More-effective population-based lifestyle modifications are required to prevent progression to hypertension and reduce the increasing burden of cardiovascular disease in China.
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Affiliation(s)
- Wei-Hong Zhang
- Department of Basic Medical Sciences, Nursing College, Zhengzhou University, Zhengzhou, China
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Lin YJ, Peng LN, Chen LK, Lin MH, Hwang SJ. Risk factors of potentially inappropriate medications among older patients visiting the community health center in rural Taiwan. Arch Gerontol Geriatr 2011; 53:225-8. [DOI: 10.1016/j.archger.2010.11.017] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2010] [Revised: 11/13/2010] [Accepted: 11/15/2010] [Indexed: 12/20/2022]
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Peng LN, Liu CL, Lin MH, Hwang SJ, Chen LK. Nondiabetic older adults with untreated hypertension in Taiwan: Treatment implication in elderly hypertension. ACTA ACUST UNITED AC 2011. [DOI: 10.1016/j.jcgg.2011.03.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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