Objective: Prehypertensives (office BP 120"“139/80"“89 mmHg) have an increased risk of cardiovascular morbidity and mortality compared with normotensives (office BP <120/80 mmHg). The aim of the present study was to assess the risk of cardiovascular (CV) events in prehypertensives with and without masked hypertension. Design and methods:In this observational prospective study 207 prehypertensives (102 M, 105 F, age 49.5±13 years, office BP 127/80±10/7 mmHg), with other CV risk factors (cigarette smoking 17.4%, total cholesterol 195±38 mg/dl, body mass index 25±3 kg/m²) but no history or signs of CV disease or diabetes, underwent clinical examination, ECG and ambulatory BP monitoring and were followed-up for 240±52 months or until CV events occurrence. Masked hypertension (in 65/207 subjects, 31.4%) was diagnosed on the basis of a daytime ambulatory BP >135/85 mmHg. Cox regression analysis was performed to assess variables that could predict CV events. Results:In the follow-up 25 CV events occurred: 5 myocardial revascularization procedures, 7 fatal or non-fatal coronary events and 13 fatal or non-fatal cerebrovascular events. CV events were predicted (each pseudo r² ranging from 0.23 to 0.31) by age (t=2.92, p=0.003), body mass index (t=2.44, p=0.015), total cholesterol (t=2.78, p=0.005), nighttime ambulatory diastolic BP (66±8 mmHg, t=2.34, p=0.019). CV prognosis was non-significantly (p=0.07) related to cigarette smoking and unrelated to other office or ambulatory BP parameters or masked hypertension. Conclusions:In this observational study the incidence of CV events (12%) in prehypertensives was similar to the CV outcome reported in epidemiological surveys. The results of this study suggest that in subjects with prehypertension traditional CV risk factors, as lipid disorders, overweight and cigarette smoking, could be similarly important as ambulatory hypertension in the prediction of an adverse CV prognosis.
Traditional risk factors and nighttime diastolic blood pressure predict cardiovascular events in prehypertensives / Pannarale, Giuseppe; Moroni, Carlo; Gentile, P.; Valente, L.; Licitra, R.; Lopreiato, F.; Truscelli, G.; Barillà, F.; Puddu, P. E.. - In: JOURNAL OF HYPERTENSION. - ISSN 0263-6352. - ELETTRONICO. - 31:(2013). (Intervento presentato al convegno 23° European Meeting on Hypertension and Cardiovascular Protection tenutosi a Milano nel 14-17/06/2013).
Traditional risk factors and nighttime diastolic blood pressure predict cardiovascular events in prehypertensives
PANNARALE, Giuseppe;MORONI, Carlo;G. Truscelli;
2013
Abstract
Objective: Prehypertensives (office BP 120"“139/80"“89 mmHg) have an increased risk of cardiovascular morbidity and mortality compared with normotensives (office BP <120/80 mmHg). The aim of the present study was to assess the risk of cardiovascular (CV) events in prehypertensives with and without masked hypertension. Design and methods:In this observational prospective study 207 prehypertensives (102 M, 105 F, age 49.5±13 years, office BP 127/80±10/7 mmHg), with other CV risk factors (cigarette smoking 17.4%, total cholesterol 195±38 mg/dl, body mass index 25±3 kg/m²) but no history or signs of CV disease or diabetes, underwent clinical examination, ECG and ambulatory BP monitoring and were followed-up for 240±52 months or until CV events occurrence. Masked hypertension (in 65/207 subjects, 31.4%) was diagnosed on the basis of a daytime ambulatory BP >135/85 mmHg. Cox regression analysis was performed to assess variables that could predict CV events. Results:In the follow-up 25 CV events occurred: 5 myocardial revascularization procedures, 7 fatal or non-fatal coronary events and 13 fatal or non-fatal cerebrovascular events. CV events were predicted (each pseudo r² ranging from 0.23 to 0.31) by age (t=2.92, p=0.003), body mass index (t=2.44, p=0.015), total cholesterol (t=2.78, p=0.005), nighttime ambulatory diastolic BP (66±8 mmHg, t=2.34, p=0.019). CV prognosis was non-significantly (p=0.07) related to cigarette smoking and unrelated to other office or ambulatory BP parameters or masked hypertension. Conclusions:In this observational study the incidence of CV events (12%) in prehypertensives was similar to the CV outcome reported in epidemiological surveys. The results of this study suggest that in subjects with prehypertension traditional CV risk factors, as lipid disorders, overweight and cigarette smoking, could be similarly important as ambulatory hypertension in the prediction of an adverse CV prognosis.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
