Impact of High-Normal Blood Pressure on the Risk of Cardiovascular Disease

Background Information is limited regarding the risk of cardiovascular disease in persons with high-normal blood pressure (systolic pressure of 130 to 139 mm Hg, diastolic pressure of 85 to 89 mm Hg, or both). Methods We investigated the association between blood-pressure category at base line and the incidence of cardiovascular disease on follow-up among 6859 participants in the Framingham Heart Study who were initially free of hypertension and cardiovascular disease. Results A stepwise increase in cardiovascular event rates was noted in persons with higher base-line blood-pressure categories. The 10-year cumulative incidence of cardiovascular disease in subjects 35 to 64 years of age who had high-normal blood pressure was 4 percent (95 percent confidence interval, 2 to 5 percent) for women and 8 percent (95 percent confidence interval, 6 to 10 percent) for men; in older subjects (those 65 to 90 years old), the incidence was 18 percent (95 percent confidence interval, 12 to 23 percent) for women and 25 p...

[1]  T. Dawber,et al.  Epidemiological approaches to heart disease: the Framingham Study. , 1951, American journal of public health and the nation's health.

[2]  W. Kannel,et al.  An investigation of coronary heart disease in families. The Framingham offspring study. , 1979, American journal of epidemiology.

[3]  D. Cox,et al.  Analysis of Survival Data. , 1986 .

[4]  D L Sackett,et al.  An assessment of clinically useful measures of the consequences of treatment. , 1988, The New England journal of medicine.

[5]  R. Collins,et al.  Blood pressure, stroke, and coronary heart disease Part 2, short-term reductions in blood pressure: overview of randomised drug trials in their epidemiological context , 1990, The Lancet.

[6]  R. Collins,et al.  Blood pressure, stroke, and coronary heart disease Part 1, prolonged differences in blood pressure: prospective observational studies corrected for the regression dilution bias , 1990, The Lancet.

[7]  W. Kannel,et al.  High-normal blood pressure progression to hypertension in the Framingham Heart Study. , 1991, Hypertension.

[8]  J. Neaton,et al.  Serum cholesterol, blood pressure, cigarette smoking, and death from coronary heart disease. Overall findings and differences by age for 316,099 white men. Multiple Risk Factor Intervention Trial Research Group. , 1992, Archives of internal medicine.

[9]  James D. Neaton,et al.  Serum Cholesterol, Blood Pressure, Cigarette Smoking, and Death From Coronary Heart Disease Overall Findings and Differences by Age for 316099 White Men , 1992 .

[10]  D. Levy,et al.  The natural history of borderline isolated systolic hypertension. , 1993, The New England journal of medicine.

[11]  A. Zanchetti,et al.  Ultrasonographic evaluation of cardiac and vascular changes in young borderline hypertensives. , 1993, Cardiology.

[12]  J. Neaton,et al.  Blood pressure, systolic and diastolic, and cardiovascular risks. US population data. , 1993, Archives of internal medicine.

[13]  P Barham,et al.  Management of raised blood pressure in New Zealand: a discussion document. , 1993, BMJ.

[14]  P Whelton,et al.  Prevalence of hypertension in the US adult population. Results from the Third National Health and Nutrition Examination Survey, 1988-1991. , 1995, Hypertension.

[15]  L. Kuller,et al.  Impact of systolic and diastolic blood pressure on cardiovascular mortality , 1995 .

[16]  D. Sackett,et al.  The number needed to treat: a clinically useful measure of treatment effect , 1995, BMJ.

[17]  S. Graff-Iversen,et al.  Left ventricular diastolic function in young men with high normal blood pressure. , 1996, The Canadian journal of cardiology.

[18]  W. Kannel.  Blood pressure as a cardiovascular risk factor: prevention and treatment. , 1996, JAMA.

[19]  B. Psaty,et al.  Health outcomes associated with antihypertensive therapies used as first-line agents. A systematic review and meta-analysis. , 1997, JAMA.

[20]  Jan A Staessen,et al.  Randomised double-blind comparison of placebo and active treatment for older patients with isolated systolic hypertension , 1997, The Lancet.

[21]  J. Cutler,et al.  Effect of Antihypertensive Drug Treatment on Cardiovascular Outcomes in Women and Men , 1997, Annals of Internal Medicine.

[22]  G. Mancia,et al.  Prevention of coronary heart disease in clinical practice. Summary of recommendations of the Second Joint Task Force of European and other Societies on Coronary Prevention. , 1998, Blood pressure.

[23]  A. Dyer,et al.  Impact of major cardiovascular disease risk factors, particularly in combination, on 22-year mortality in women and men. , 1998, Archives of internal medicine.

[24]  Z. Li,et al.  Blood pressure, cholesterol, and stroke in eastern Asia , 1998, The Lancet.

[25]  N. Doba,et al.  Characteristics of cardiovascular morphology and function in the high-normal subset of hypertension defined by JNC-VI recommendations. , 1999, Hypertension research : official journal of the Japanese Society of Hypertension.

[26]  A. Dyer,et al.  Low risk-factor profile and long-term cardiovascular and noncardiovascular mortality and life expectancy: findings for 5 large cohorts of young adult and middle-aged men and women. , 1999, JAMA.

[27]  Bruce Neal,et al.  1999 World Health Organization-International Society of Hypertension Guidelines for the Management of Hypertension. Guidelines Subcommittee. , 1999, Journal of hypertension.

[28]  R. Collins,et al.  Underestimation of risk associations due to regression dilution in long-term follow-up of prospective studies. , 1999, American journal of epidemiology.

[29]  D. Levy,et al.  Cross-classification of JNC VI blood pressure stages and risk groups in the Framingham Heart Study. , 1999, Archives of internal medicine.

[30]  P. Whelton,et al.  Long-term absolute benefit of lowering blood pressure in hypertensive patients according to the JNC VI risk stratification. , 2000, Hypertension.

[31]  E. Feskens,et al.  The Relation between Blood Pressure and Mortality Due to Coronary Heart Disease among Men in Different Parts of the World , 2000 .