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The 10-year incidence of hypertension across blood pressure categories in a population-based cohort in southwestern Sweden

Lindblad, Ulf ; Lundholm, Klara ; Eckner, Jenny LU ; Li, Ying ; Råstam, Lennart LU ; Hellgren, I. Margareta and Daka, Bledar (2021) In BMC Cardiovascular Disorders 21(1).
Abstract

Background: To explore the determinants of incident hypertension, and especially the impact of baseline blood pressure categories, in a representative Swedish population. Methods: A 10-year longitudinal study of residents aged 30–74. Blood pressures were measured and categorized according to ESH guidelines with optimal blood pressure < 120/80 mmHg, normal 120–129/80–84 mmHg, and high normal 130–139/85–89 mmHg. Incident hypertension was defined as ongoing treatment or three consecutive blood pressure readings ≥ 140/ ≥ 90 mmHg (one or both) at follow-up, while those with ≥ 140 and/or ≥ 90 mmHg at only one or two visits were labelled as unstable. After excluding subjects with hypertension, ongoing blood pressure lowering medication or a... (More)

Background: To explore the determinants of incident hypertension, and especially the impact of baseline blood pressure categories, in a representative Swedish population. Methods: A 10-year longitudinal study of residents aged 30–74. Blood pressures were measured and categorized according to ESH guidelines with optimal blood pressure < 120/80 mmHg, normal 120–129/80–84 mmHg, and high normal 130–139/85–89 mmHg. Incident hypertension was defined as ongoing treatment or three consecutive blood pressure readings ≥ 140/ ≥ 90 mmHg (one or both) at follow-up, while those with ≥ 140 and/or ≥ 90 mmHg at only one or two visits were labelled as unstable. After excluding subjects with hypertension, ongoing blood pressure lowering medication or a previous CVD event at baseline, 1099 remained for further analyses. Results: Sixteen (2.6%) subjects with optimal baseline blood pressure had hypertension at follow up. Corresponding numbers for subjects with normal, high normal and unstable blood pressure were 55 (19.4%), 50 (39.1%) and 46 (74.2%), respectively. Compared with subjects in optimal group those in normal, high normal and unstable blood pressure categories had significantly higher risk to develop manifest hypertension with odds ratios OR and (95% CI) of 7.04 (3.89–12.7), 17.1 (8.88–33.0) and 84.2 (37.4–190), respectively, with adjustment for age, BMI and family history for hypertension. The progression to hypertension was also independently predicted by BMI (p < 0.001), however, not by age. Conclusions: Subjects with high normal or unstable blood pressure should be identified in clinical practice, evaluated for global hypertension risk and offered personalized advice on lifestyle modification for early prevention of manifest hypertension and cardiovascular disease.

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author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Cohort study, High normal blood pressure, Incident hypertension, Population survey, Prehypertension
in
BMC Cardiovascular Disorders
volume
21
issue
1
article number
523
publisher
BioMed Central (BMC)
external identifiers
  • scopus:85118262705
  • pmid:34715783
ISSN
1471-2261
DOI
10.1186/s12872-021-02334-6
language
English
LU publication?
yes
additional info
Publisher Copyright: © 2021, The Author(s).
id
4147acf8-7a24-4a00-8715-d54cc75b416d
date added to LUP
2021-11-22 11:12:56
date last changed
2024-09-22 05:59:08
@article{4147acf8-7a24-4a00-8715-d54cc75b416d,
  abstract     = {{<p>Background: To explore the determinants of incident hypertension, and especially the impact of baseline blood pressure categories, in a representative Swedish population. Methods: A 10-year longitudinal study of residents aged 30–74. Blood pressures were measured and categorized according to ESH guidelines with optimal blood pressure &lt; 120/80 mmHg, normal 120–129/80–84 mmHg, and high normal 130–139/85–89 mmHg. Incident hypertension was defined as ongoing treatment or three consecutive blood pressure readings ≥ 140/ ≥ 90 mmHg (one or both) at follow-up, while those with ≥ 140 and/or ≥ 90 mmHg at only one or two visits were labelled as unstable. After excluding subjects with hypertension, ongoing blood pressure lowering medication or a previous CVD event at baseline, 1099 remained for further analyses. Results: Sixteen (2.6%) subjects with optimal baseline blood pressure had hypertension at follow up. Corresponding numbers for subjects with normal, high normal and unstable blood pressure were 55 (19.4%), 50 (39.1%) and 46 (74.2%), respectively. Compared with subjects in optimal group those in normal, high normal and unstable blood pressure categories had significantly higher risk to develop manifest hypertension with odds ratios OR and (95% CI) of 7.04 (3.89–12.7), 17.1 (8.88–33.0) and 84.2 (37.4–190), respectively, with adjustment for age, BMI and family history for hypertension. The progression to hypertension was also independently predicted by BMI (p &lt; 0.001), however, not by age. Conclusions: Subjects with high normal or unstable blood pressure should be identified in clinical practice, evaluated for global hypertension risk and offered personalized advice on lifestyle modification for early prevention of manifest hypertension and cardiovascular disease.</p>}},
  author       = {{Lindblad, Ulf and Lundholm, Klara and Eckner, Jenny and Li, Ying and Råstam, Lennart and Hellgren, I. Margareta and Daka, Bledar}},
  issn         = {{1471-2261}},
  keywords     = {{Cohort study; High normal blood pressure; Incident hypertension; Population survey; Prehypertension}},
  language     = {{eng}},
  number       = {{1}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{BMC Cardiovascular Disorders}},
  title        = {{The 10-year incidence of hypertension across blood pressure categories in a population-based cohort in southwestern Sweden}},
  url          = {{http://dx.doi.org/10.1186/s12872-021-02334-6}},
  doi          = {{10.1186/s12872-021-02334-6}},
  volume       = {{21}},
  year         = {{2021}},
}