Prehypertension, diabetes, and cardiovascular disease risk in a population-based sample - The Strong Heart Study

被引:198
作者
Zhang, Y
Lee, ET
Devereux, RB
Yeh, JL
Best, LG
Fabsitz, RR
Howard, BV
机构
[1] Univ Oklahoma, Hlth Sci Ctr, Coll Publ Hlth, Ctr Amer Indian Hlth Res, Oklahoma City, OK 73190 USA
[2] Cornell Univ, Med Ctr, New York, NY 10021 USA
[3] Missouri Breaks Ind Res Inc, Timber Lake, SD USA
[4] NHLBI, Epidemiol & Biometry Program, Bethesda, MD 20892 USA
[5] MedStar Res Inst, Washington, DC USA
关键词
cardiovascular disease; cohort study; diabetes mellitus; prehypertension;
D O I
10.1161/01.HYP.0000205119.19804.08
中图分类号
R6 [外科学];
学科分类号
1002 ; 100210 ;
摘要
There are few data about the impact of the recently-defined category of prehypertension (systolic blood pressure 120 to 139 mm Hg or diastolic blood pressure 80 to 89 mm Hg) on cardiovascular disease incidence. It is also unknown whether this association differs between individuals with or without diabetes. A total of 2629 Strong Heart Study participants free from hypertension and cardiovascular disease at baseline examination were followed for 12 years to observe incident cardiovascular disease. Approximately 42% of the 2629 participants had diabetes. We assessed the prevalence of prehypertension and the hazard ratios of incident cardiovascular disease associated with prehypertension. Prehypertension was more prevalent in diabetic than nondiabetic participants (59.4% versus 48.2%, P < 0.001 adjusted for age). Compared with nondiabetic participants with normal blood pressure, the hazard ratios of cardiovascular disease were 3.70 (95% confidence interval: 2.66, 5.15) for those with both prehypertension and diabetes, 1.80 (1.28, 2.54) for those with prehypertension alone and 2.90 (2.03, 4.16) for those with diabetes alone. Impaired glucose tolerance or impaired fasting glucose also greatly increased the cardiovascular disease risk in prehypertensive people. Clinical investigation of more aggressive interventions, such as drug treatment for blood pressure control for prehypertensive individuals with impaired fasting glucose, impaired glucose tolerance, or diabetes is warranted.
引用
收藏
页码:410 / 414
页数:5
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