-
Future Cardiology Jan 2013Hypertension (HTN) and prehypertension (pre-HTN) have been identified as independent risk factors for adverse cardiovascular events. Recently, increased psychosocial... (Review)
Review
Hypertension (HTN) and prehypertension (pre-HTN) have been identified as independent risk factors for adverse cardiovascular events. Recently, increased psychosocial stress and work stress have contributed to the increased prevalence of HTN and pre-HTN, in addition to the contribution of obesity, diabetes, poor food habits and physical inactivity. Irrespective of the etiology, sympathetic overactivity has been recognized as the main pathophysiologic mechanism in the genesis of HTN and pre-HTN. Sympathovagal imbalance owing to sympathetic overactivity and vagal withdrawal is reported to be the basis of many clinical disorders. However, the role played by vagal withdrawal has been under-reported. In this review, we have analyzed the pathophysiologic involvement of sympathovagal imbalance in the development of HTN and pre-HTN, and the link of sympathovagal imbalance to cardiovascular dysfunctions. We have emphasized that adaptation to a healthier lifestyle will help improve sympathovagal homeostasis and prevent the occurrence of HTN and pre-HTN.
Topics: Homeostasis; Humans; Hypertension; Life Style; Prehypertension; Risk Factors; Sympathetic Nervous System; Vagus Nerve
PubMed: 23259475
DOI: 10.2217/fca.12.80 -
Current Hypertension Reports Oct 2014This review addresses to what extent out-of-office blood pressure, the ambulatory blood pressure monitoring and the self-measured home blood pressure, refines... (Review)
Review
This review addresses to what extent out-of-office blood pressure, the ambulatory blood pressure monitoring and the self-measured home blood pressure, refines conventional blood pressure-based risk stratification across increasing blood pressure categories, in particular individuals assumed to be associated with no or only mildly increased risk. Compared with sustained normotension, individuals with prehypertension as well as masked hypertension tend to be developed to true hypertension. Ambulatory blood pressure measurement refines risk stratification among prehypertensive people. Home blood pressure is more useful for the prediction of cerebrovascular diseases than conventional blood pressure, by replacing information from conventional to home blood pressure in risk stratification system. Furthermore, the two participant-level meta-analyses demonstrated that the out-of-office blood pressure substantially refines risk stratification in normotension and prehypertension, particularly among participants with masked hypertension. Properly organized randomized clinical trials are required to demonstrate that identification and treatment of masked hypertension, compared with the current standard care based on conventional pressure, lead to the reduction of cardiovascular diseases in population and are cost-effective.
Topics: Blood Pressure; Blood Pressure Determination; Blood Pressure Monitoring, Ambulatory; Female; Humans; Hypertension; Prehypertension; Risk
PubMed: 25139777
DOI: 10.1007/s11906-014-0478-0 -
Hypertension (Dallas, Tex. : 1979) Feb 2021Hypertension, particularly in middle age, has been associated with worse cognitive function, but evidence is inconclusive. This study investigated whether hypertension,...
Hypertension, particularly in middle age, has been associated with worse cognitive function, but evidence is inconclusive. This study investigated whether hypertension, prehypertension, age, and duration of diagnosis, as well as blood pressure control, are associated with a decline in cognitive performance in ELSA-Brasil participants. This longitudinal study included 7063 participants, mean age 58.9 years at baseline (2008-2010), who attended visit 2 (2012-2014). Cognitive performance was measured in both visits and evaluated by the standardized scores of the memory, verbal fluency, trail B tests, and global cognitive score. The associations were investigated using linear mixed models. Hypertension and prehypertension at baseline were associated with decline in global cognitive score; being hypertension associated with reduction in memory test; and prehypertension with reduction in fluency test. Hypertension diagnose ≥55 years was associated with lower global cognitive and memory test scores, and hypertension diagnose <55 years with lower memory test scores. Duration of hypertension diagnoses was not associated with any marker of cognitive function decline. Among treated individuals, blood pressure control at baseline was inversely associated with the decline in both global cognitive and memory test scores. In this relatively young cohort, hypertension, prehypertension, and blood pressure control were independent predictors of cognitive decline in distinct abilities. Our findings suggest that both lower and older age of hypertension, but not duration of diagnosis, were associated with cognitive decline in different abilities. In addition to hypertension, prehypertension and pressure control might be critical for the preservation of cognitive function.
Topics: Antihypertensive Agents; Brazil; Cognition; Cognitive Dysfunction; Cross-Sectional Studies; Female; Humans; Hypertension; Longitudinal Studies; Male; Memory; Middle Aged; Neuropsychological Tests; Prehypertension
PubMed: 33307849
DOI: 10.1161/HYPERTENSIONAHA.120.16080 -
Medicine and Science in Sports and... Jun 2019This systematic umbrella review examines and updates the evidence on the relationship between physical activity (PA) and blood pressure (BP) presented in the 2008...
PURPOSE
This systematic umbrella review examines and updates the evidence on the relationship between physical activity (PA) and blood pressure (BP) presented in the 2008 Physical Activity Guidelines Advisory Committee Scientific Report.
METHODS
We performed a systematic review to identify systematic reviews and meta-analyses involving adults with normal BP, prehypertension, and hypertension published from 2006 to February 2018.
RESULTS
In total, 17 meta-analyses and one systematic review with 594,129 adults ≥18 yr qualified. Strong evidence demonstrates: 1) an inverse dose-response relationship between PA and incident hypertension among adults with normal BP; 2) PA reduces the risk of cardiovascular disease (CVD) progression among adults with hypertension; 3) PA reduces BP among adults with normal BP, prehypertension, and hypertension; and 4) the magnitude of the BP response to PA varies by resting BP, with greater benefits among adults with prehypertension than normal BP. Moderate evidence indicates the relationship between resting BP and the magnitude of benefit does not vary by PA type among adults with normal BP, prehypertension, and hypertension. Limited evidence suggests the magnitude of the BP response to PA varies by resting BP among adults with hypertension. Insufficient evidence is available to determine if factors such as sex, age, race/ethnicity, socioeconomic status, and weight status or the frequency, intensity, time, and duration of PA influence the associations between PA and BP.
CONCLUSIONS
Future research is needed that adheres to standard BP measurement protocols and classification schemes to better understand the influence of PA on the risk of comorbid conditions, health-related quality of life, and CVD progression and mortality; the interactive effects between PA and antihypertensive medication use; and the immediate BP-lowering benefits of PA.
Topics: Biomedical Research; Blood Pressure; Cardiovascular Diseases; Disease Progression; Exercise; Exercise Therapy; Humans; Hypertension; Practice Guidelines as Topic; Prehypertension; Risk Reduction Behavior; Socioeconomic Factors
PubMed: 31095088
DOI: 10.1249/MSS.0000000000001943 -
Cardiology Clinics Nov 2010Hypertension is the leading risk factor for death worldwide, even surpassing tobacco use, high blood glucose, high blood cholesterol, and obesity. Globally, the... (Comparative Study)
Comparative Study Review
Hypertension is the leading risk factor for death worldwide, even surpassing tobacco use, high blood glucose, high blood cholesterol, and obesity. Globally, the estimated prevalence of hypertension is nearly 1 billion persons with an annual mortality of almost 7.5 million deaths. In the United States, hypertension affects an estimated 65 million Americans, and is the leading risk-factor cause of death in women and only second to tobacco use as a contributory cause of death in men. Multiple sources of data from prospective observational, cohort, and randomized controlled clinical trials show that hypertension and its complications are highly preventable when the raised blood pressure is prevented, or treated and controlled. To promote positive behavior change and create a broader impact on public health, it has become necessary to leverage multilevel stakeholders such as all health care providers, researchers, policy makers, schools, the food industry, and the general public to drive policy changes and future innovation from research and development endeavors, and to emphasize the importance of diet-related lifestyle modifications to effectively prevent and control hypertension and prehypertension.
Topics: Cause of Death; Cooperative Behavior; Cross-Sectional Studies; Feeding Behavior; Female; Humans; Hypertension; Interdisciplinary Communication; Male; Nutritional Requirements; Nutritive Value; Patient Care Team; Prehypertension
PubMed: 20937449
DOI: 10.1016/j.ccl.2010.08.001 -
Cardiovascular Therapeutics Dec 2010
Topics: Antihypertensive Agents; Blood Pressure; Cardiovascular Diseases; Humans; Hypertension; Prehypertension; Risk Assessment; Risk Factors; Risk Reduction Behavior; Treatment Outcome
PubMed: 21050419
DOI: 10.1111/j.1755-5922.2010.00234.x -
International Journal of Cardiology Jan 2017Prehypertension has a high risk of progression to hypertension, and intensive lifestyle modification including regular exercise is recommended for the management of...
BACKGROUND
Prehypertension has a high risk of progression to hypertension, and intensive lifestyle modification including regular exercise is recommended for the management of prehypertensive individuals. However, data on the association between exercise capacity and hypertension status are limited. Therefore, we aimed 1) to define the characteristics of prehypertension, focusing on metabolic aspects and exercise capacity, and 2) to elucidate determinants of exercise capacity in healthy individuals without hypertension.
METHODS
We retrospectively identified 741 normotensive healthy subjects (mean age, 52.6±8.8years; 57.9% men) who underwent consecutive cardiopulmonary exercise testing. The participants were categorized into two groups: the optimal blood pressure (BP) (systolic BP<120mmHg and diastolic BP<80mmHg, n=364) and prehypertension (systolic BP 120-139mmHg and/or diastolic BP 80-89mmHg, n=377) groups. Exercise capacity was assessed with peak oxygen consumption.
RESULTS
The prehypertension group showed metabolic syndrome characteristics, and had increased left ventricular mass index and impaired diastolic function. However, no significant differences in exercise capacity were found between the optimal BP and prehypertension groups (peak VO, 25.3±7.2 vs. 25.8±7.3mL/kg/min, p=0.327). Age, resting heart rate, and fat percentage were identified as independent determinants of exercise capacity (p<0.001 for all).
CONCLUSIONS
Prehypertension is associated with metabolic disarrangement and preclinical target organ damage but not with exercise capacity. Exercise capacity is determined by age, resting heart rate, and body composition in relatively healthy individuals who do not have hypertension.
Topics: Adult; Atherosclerosis; Body Composition; Exercise Test; Exercise Tolerance; Female; Humans; Male; Middle Aged; Oxygen Consumption; Prehypertension; Retrospective Studies; Risk Factors
PubMed: 27843053
DOI: 10.1016/j.ijcard.2016.11.044 -
Bulletin of Experimental Biology and... Mar 2021The prognostic models assessing the risk of prehypertension in coming 1-2-year period for 30-60-year-old subjects were developed with the help of computer recognition...
The prognostic models assessing the risk of prehypertension in coming 1-2-year period for 30-60-year-old subjects were developed with the help of computer recognition technology using 6 recognition methods. These models are based on the content of molecular markers in blood serum and the risk factors for the development of prehypertension in men and women who had "optimal" BP for last 3 years and in patients with newly diagnosed prehypertension. The models were compared for their prediction power. The most effective model was obtained with gradient boosting method based on the content of molecular markers. It is characterized with a high predictive power (ROC AUC=0.76), specificity (96.4%), and overall accuracy (86.6%) accompanied with close relationship between prognosis and actual symptoms of prehypertension (p=0.001).
Topics: Adult; Biomarkers; Blood Pressure; Humans; Middle Aged; Prehypertension; Prognosis
PubMed: 33788117
DOI: 10.1007/s10517-021-05134-2 -
BMC Cardiovascular Disorders Aug 2017Existing evidence suggests that the cardiovascular morbidities are increasing among pre-hypertensive individuals compared to normal. The aim of this study was to...
BACKGROUND
Existing evidence suggests that the cardiovascular morbidities are increasing among pre-hypertensive individuals compared to normal. The aim of this study was to evaluate the prevalence of prehypertension, hypertension and to identify psychosocial risk factors for prehypertension among university students in Association of South East Asian Nation (ASEAN) countries.
METHODS
Based on a cross-sectional survey, the total sample included 4649 undergraduate university students (females = 65.3%; mean age 20.5, SD = 2.9, age range of 18-30 years) from 7 ASEAN countries (Indonesia, Laos, Malaysia, Myanmar, Philippines, Thailand and Vietnam). Blood pressure, anthropometric, health behaviour and psychosocial variables were measured.
RESULTS
Overall, 19.0% of the undergraduate university students across ASEAN countries had prehypertension, 6.7% hypertension and 74.2% were normotensives. There was country variation in prehypertension prevalence, ranging from 11.3% in Indonesia and 11.5% in Malaysia to above 18% in Laos, Myanmar and Thailand. In multivariate analysis, sociodemographic variables (male gender, living in an upper middle income country, and living on campus or off campus on their own), nutrition and weight variables (not being underweight and obese, having once or more times soft drinks in a day and never or rarely having chocolate or candy), heavy drinking and having depressive symptoms were associated with prehypertension.
CONCLUSION
The study found a high prevalence of prehypertension in ASEAN university students. Several psychosocial risk factors including male gender, obesity, soft drinks consumption, heavy drinking and depression symptoms have been identified which can help in intervention programmes.
Topics: Adolescent; Adult; Alcohol Drinking in College; Asia; Asian People; Carbonated Beverages; Depression; Feeding Behavior; Female; Health Status; Humans; Male; Multivariate Analysis; Obesity; Prehypertension; Prevalence; Risk Assessment; Risk Factors; Sex Factors; Students; Universities; Young Adult
PubMed: 28835205
DOI: 10.1186/s12872-017-0666-3 -
BMC Medicine Aug 2013Prospective cohort studies of prehypertension and the incidence of cardiovascular disease (CVD) are controversial after adjusting for other cardiovascular risk factors.... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Prospective cohort studies of prehypertension and the incidence of cardiovascular disease (CVD) are controversial after adjusting for other cardiovascular risk factors. This meta-analysis evaluated the association between prehypertension and CVD morbidity.
METHODS
Databases (PubMed, EMBASE and the Cochrane Library) and conference proceedings were searched for prospective cohort studies with data on prehypertension and cardiovascular morbidity. Two independent reviewers assessed the reports and extracted data. The relative risks (RRs) of CVD, coronary heart disease (CHD) and stroke morbidity were calculated and reported with 95% confidence intervals (95% CIs). Subgroup analyses were conducted on blood pressure, age, gender, ethnicity, follow-up duration, number of participants and study quality.
RESULTS
Pooled data included the results from 468,561 participants from 18 prospective cohort studies. Prehypertension elevated the risks of CVD (RR = 1.55; 95% CI = 1.41 to 1.71); CHD (RR = 1.50; 95% CI = 1.30 to 1.74); and stroke (RR = 1.71; 95% CI = 1.55 to 1.89). In the subgroup analyses, even for low-range prehypertension, the risk of CVD was significantly higher than for optimal BP (RR = 1.46, 95% CI = 1.32 to 1.62), and further increased with high-range prehypertension (RR = 1.80, 95% CI = 1.41 to 2.31). The relative risk was significantly higher in the high-range prehypertensive populations than in the low-range populations (χ2= 5.69, P = 0.02). There were no significant differences among the other subgroup analyses (P>0.05).
CONCLUSIONS
Prehypertension, even in the low range, elevates the risk of CVD after adjusting for multiple cardiovascular risk factors.
Topics: Blood Pressure; Cardiovascular Diseases; Cohort Studies; Humans; Hypertension; Incidence; Prehypertension; Prospective Studies
PubMed: 23915102
DOI: 10.1186/1741-7015-11-177