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Prehypertension poses heightened risk of major adverse cardiovascular events

17 Mar 2020

Prehypertensive individuals are at high risk of major adverse cardiovascular events (MACE), cardiovascular disease (CVD) mortality and stroke, as reported in a study.

Researchers followed a cohort of 38,765 adults aged ≥35 years, among whom 7,366 had normal BP, 18,095 had prehypertension, and 13,304 had hypertension. Over a median follow-up period of 12.5 years, 3,958 individuals developed MACE, including 1,982 CVD deaths, 3,030 strokes and 648 myocardial infarction.

The age and sex-adjusted incidence of MACE and its subtypes progressively increased with blood pressure (BP) level elevation. Incidence rates per 100,000 person-years were 478.8 among participants with normal BP, 628.2 among those with prehypertension, and 1,107.3 among those with hypertension; the difference between prehypertension and normal BP was significant (p<0.001).

Multivariable Cox proportional hazards analysis revealed that compared with normal BP, prehypertension contributed to significant increases in the risks of incident MACE (hazard ratio [HR], 1.337, 95 percent confidence interval [CI], 1.186–1.508; p<0.001), CVD mortality (HR, 1.331, 95 percent CI, 1.109–1.597; p=0.002) and stroke (HR, 1.424, 95 percent CI, 1.237–1.639; p<0.001) but not myocardial infarction (p>0.05).

The present data underscore the important role that prehypertension plays in MACE, researchers said, emphasizing the urgent need for BP monitoring and early intervention in prehypertensive individuals.

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