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Metabolic characteristics of prehypertension: role of classification criteria and gender

Natali, Andrea; Muscelli, Elza; Casolaro, Arturo; Nilsson, Peter LU ; Melander, Ole; Lalic, Nebojsa; Ferrannini, Ele and Petrie, John R. (2009) In Journal of Hypertension 27(12). p.2394-2402
Abstract
Objective We tested whether men and women in the European Society of Hypertension (ESH) high normal and normal blood pressure (BP) categories, all included in the the Seventh Joint National Committee (JNC 7) prehypertension group, share similar metabolic characteristics and whether they differ from men and women with optimal BP (<120/80 mmHg). Methods BP (multiple measurements with a standardized automatic device), insulin sensitivity (euglycaemic clamp), oral glucose tolerance test (OGTT), carotid intima-media-thickness (IMT, echo), family history (questionnaire), physical activity (accelerometer), and anthropometrics (bioimpedance) were evaluated in the 1384 healthy European individuals ranging from 30-60 years participating in the... (More)
Objective We tested whether men and women in the European Society of Hypertension (ESH) high normal and normal blood pressure (BP) categories, all included in the the Seventh Joint National Committee (JNC 7) prehypertension group, share similar metabolic characteristics and whether they differ from men and women with optimal BP (<120/80 mmHg). Methods BP (multiple measurements with a standardized automatic device), insulin sensitivity (euglycaemic clamp), oral glucose tolerance test (OGTT), carotid intima-media-thickness (IMT, echo), family history (questionnaire), physical activity (accelerometer), and anthropometrics (bioimpedance) were evaluated in the 1384 healthy European individuals ranging from 30-60 years participating in the multicentre study Relationship between Insulin Sensitivity and Cardiovascular disease (RISC). Results BMI and waist-to-hip ratio were higher (both P<0.05 adjusted for age and recruiting centre) in men and women with high normal (but not normal) BP with respect to optimal BP. Similarly, in women (after adjustment for study centre, age, physical activity, and waist), serum triglycerides and carotid IMT were higher in those with high normal (but not normal) BP; moreover, in this group there was a higher prevalence of glucose-intolerance (21.8 versus 9.7%, P=0.02) and insulin sensitivity tended to be lower (P=0.07). Insulin sensitivity and diastolic blood pressure were weakly related variables displaying a nonlinear association with a threshold below the normal BP values and no interaction with family history of hypertension. Conclusion The JNC 7 category prehypertension identifies a dishomogeneous group of individuals whereas the ESH classification, particularly in women, was more accurate in identifying both the predisease and the healthy phenotype. Insulin resistance is not a major characteristic of the condition of prehypertension. J Hypertens 27:2394-2402 (c) 2009 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
prehypertension, insulin resistance, carotid intima-media thickness, glucose tolerance
in
Journal of Hypertension
volume
27
issue
12
pages
2394 - 2402
publisher
Lippincott Williams & Wilkins
external identifiers
  • wos:000272420800014
  • scopus:73649115325
ISSN
1473-5598
DOI
10.1097/HJH.0b013e3283316c31
language
English
LU publication?
yes
id
7abd043d-f3fe-4612-ae86-47ca4df6e3ae (old id 1533473)
date added to LUP
2010-01-27 16:24:50
date last changed
2017-01-01 05:56:02
@article{7abd043d-f3fe-4612-ae86-47ca4df6e3ae,
  abstract     = {Objective We tested whether men and women in the European Society of Hypertension (ESH) high normal and normal blood pressure (BP) categories, all included in the the Seventh Joint National Committee (JNC 7) prehypertension group, share similar metabolic characteristics and whether they differ from men and women with optimal BP (&lt;120/80 mmHg). Methods BP (multiple measurements with a standardized automatic device), insulin sensitivity (euglycaemic clamp), oral glucose tolerance test (OGTT), carotid intima-media-thickness (IMT, echo), family history (questionnaire), physical activity (accelerometer), and anthropometrics (bioimpedance) were evaluated in the 1384 healthy European individuals ranging from 30-60 years participating in the multicentre study Relationship between Insulin Sensitivity and Cardiovascular disease (RISC). Results BMI and waist-to-hip ratio were higher (both P&lt;0.05 adjusted for age and recruiting centre) in men and women with high normal (but not normal) BP with respect to optimal BP. Similarly, in women (after adjustment for study centre, age, physical activity, and waist), serum triglycerides and carotid IMT were higher in those with high normal (but not normal) BP; moreover, in this group there was a higher prevalence of glucose-intolerance (21.8 versus 9.7%, P=0.02) and insulin sensitivity tended to be lower (P=0.07). Insulin sensitivity and diastolic blood pressure were weakly related variables displaying a nonlinear association with a threshold below the normal BP values and no interaction with family history of hypertension. Conclusion The JNC 7 category prehypertension identifies a dishomogeneous group of individuals whereas the ESH classification, particularly in women, was more accurate in identifying both the predisease and the healthy phenotype. Insulin resistance is not a major characteristic of the condition of prehypertension. J Hypertens 27:2394-2402 (c) 2009 Wolters Kluwer Health vertical bar Lippincott Williams &amp; Wilkins.},
  author       = {Natali, Andrea and Muscelli, Elza and Casolaro, Arturo and Nilsson, Peter and Melander, Ole and Lalic, Nebojsa and Ferrannini, Ele and Petrie, John R.},
  issn         = {1473-5598},
  keyword      = {prehypertension,insulin resistance,carotid intima-media thickness,glucose tolerance},
  language     = {eng},
  number       = {12},
  pages        = {2394--2402},
  publisher    = {Lippincott Williams & Wilkins},
  series       = {Journal of Hypertension},
  title        = {Metabolic characteristics of prehypertension: role of classification criteria and gender},
  url          = {http://dx.doi.org/10.1097/HJH.0b013e3283316c31},
  volume       = {27},
  year         = {2009},
}