Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2016 May;29(5):568-74.
doi: 10.1093/ajh/hpv156. Epub 2015 Sep 7.

Prehypertension is Associated With Abnormalities of Cardiac Structure and Function in the Atherosclerosis Risk in Communities Study

Angela B S Santos  1 , Deepak K Gupta  2 , Natalie A Bello  3 , Mauro Gori  4 , Brian Claggett  5 , Flavio D Fuchs  6 , Amil M Shah  5 , Josef Coresh  7 , A Richey Sharrett  7 , Susan Cheng  5 , Scott D Solomon  8
Affiliations
Multicenter Study

Prehypertension is Associated With Abnormalities of Cardiac Structure and Function in the Atherosclerosis Risk in Communities Study

Angela B S Santos et al. Am J Hypertens. 2016 May.

Abstract

Background: Prehypertension (blood pressure (BP) of 120-139 mm Hg systolic and/or 80-89 mm Hg diastolic) is highly prevalent and is associated with increased cardiovascular risk. Our goal was to investigate the extent to which prehypertension is associated with end-organ alterations in cardiac structure and function in a large biracial cohort of older men and women.

Methods: We studied 4,871 participants of the Atherosclerosis Risk in Communities (ARIC) study who attended visit 5 (2011-2013) and underwent two-dimensional echocardiography while free of prevalent coronary heart disease or heart failure. We categorized participants into 3 groups: optimal BP (BP <120 mm Hg and <80 mm Hg) (n = 402), prehypertension (n = 537), and hypertension (n = 3,932).

Results: Individuals with prehypertension (75±5 years) had higher left ventricular (LV) mass index and wall thickness, and higher prevalence of abnormal LV geometry than those with optimal BP (74±5 years), but lower than those with frank hypertension (76±5 years). In addition, participants with prehypertension had impairment of diastolic parameters (E/A, E' and E/E'), and had higher prevalence of mild and moderate-severe diastolic dysfunction compared to those with optimal BP, but no differences in systolic parameters. These differences in cardiac structure and function remained significant after adjusting for important clinical covariates.

Conclusion: In the ARIC cohort at visit 5, prehypertension was associated with increased LV remodeling and impaired diastolic function, but not systolic function, suggesting that even mildly elevated BP within the normal range is associated with cardiac end-organ damage.

Keywords: blood pressure; cardiovascular pathophysiology; echocardiography; prehypertension..

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Study sampling strategy.
Figure 2.
Figure 2.
Abnormal LV geometry by categories of hypertension status. Abnormal geometry was defined as presence of concentric remodeling, concentric hypertrophy or eccentric hypertrophy. Optimal BP as a reference group: *P values <0.05.
Figure 3.
Figure 3.
Diastolic dysfunction by categories of hypertension status. Abbreviations: DD, diastolic dysfunction; DF, diastolic function. All unadjusted and adjusted P values for the comparisons of optimal BP vs. prehypertension (preHTN) and optimal BP vs. hypertension (HTN) were <0.01. P values adjusted for age, sex, race, HR, body mass index (BMI), estimated glomerular filtration rate (eGFR), history of diabetes; *%’s may not add to 100 due to rounding.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, Jr, Jones DW, Materson BJ, Oparil S, Wright JT, Jr, Roccella EJ; National Heart, Lung, and Blood Institute Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure; National High Blood Pressure Education Program Coordinating Committee. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA 2003; 289:2560–2572. - PubMed
    1. Gupta AK, McGlone M, Greenway FL, Johnson WD. Prehypertension in disease-free adults: a marker for an adverse cardiometabolic risk profile. Hypertens Res 2010; 33:905–910. - PubMed
    1. Glasser SP, Judd S, Basile J, Lackland D, Halanych J, Cushman M, Prineas R, Howard V, Howard G. Prehypertension, racial prevalence and its association with risk factors: Analysis of the REasons for Geographic And Racial Differences in Stroke (REGARDS) study. Am J Hypertens 2011; 24:194–199. - PMC - PubMed
    1. Toprak A, Wang H, Chen W, Paul T, Ruan L, Srinivasan S, Berenson G. Prehypertension and black-white contrasts in cardiovascular risk in young adults: Bogalusa Heart Study. J Hypertens 2009; 27:243–250. - PubMed
    1. Vasan RS, Larson MG, Leip EP, Evans JC, O'Donnell CJ, Kannel WB, Levy D. Impact of high-normal blood pressure on the risk of cardiovascular disease. N Engl J Med 2001; 345:1291–1297. - PubMed

Publication types

MeSH terms

-