Division of Community and Family Medicine, Jichi Medical University School of Medicine, Shimotsuke, Tochigi, Japan.
J Hypertens. 2010 Aug;28(8):1630-7. doi: 10.1097/HJH.0b013e32833a8b9f.
Prehypertension is associated with an increased risk of the development of hypertension and subsequent cardiovascular disease. However, it is unclear whether the increased risk of cardiovascular disease associated with prehypertension varies by duration of follow-up (i.e., the first 5 years vs. second 5 years) or varies between nonelderly and elderly individuals.
We enrolled 11,000 community dwelling persons (6739 women and 4261 men, aged 18-90 years) from the Japanese general population, followed them for an average of 10.7 +/- 2.4 years (117,517 person-years) and evaluated the incidence of cardiovascular events (including both stroke and myocardial infarction).
In the full cohort, prehypertension was associated with a 45% higher risk of cardiovascular events than normal blood pressure after adjusting for traditional cardiovascular risk factors (hazard ratio = 1.45, P = 0.03). The risk of cardiovascular events with prehypertension during the second 5-year period was elevated in the nonelderly subgroup (<65 years) (hazard ratio = 2.13, P = 0.01), but not in the elderly subgroup (>or=65 years) (hazard ratio = 0.93, P = 0.82) (P = 0.054 for the difference in hazard ratio). The elevated risk with prehypertension during the first 5-year period was not significant in either the nonelderly (hazard ratio = 1.60, P = 0.36) or elderly (hazard ratio = 1.19, P = 0.63) group. However, the risks with prehypertension were not statistically different between the first and second 5-year period.
Prehypertension is associated with an increased 10-year risk of cardiovascular disease; the provocative finding that this risk may be especially elevated during the second 5-year period in the nonelderly requires confirmation in a larger cohort.
高血压前期与高血压和随后的心血管疾病的发展风险增加有关。 然而，尚不清楚与高血压前期相关的心血管疾病风险是否随随访时间（即前 5 年与后 5 年）而变化，或者是否在非老年和老年个体之间存在差异。
我们从日本一般人群中招募了 11000 名居住在社区的人（6739 名女性和 4261 名男性，年龄 18-90 岁），平均随访 10.7±2.4 年（117517 人年），并评估了心血管事件（包括中风和心肌梗死）的发生率。
在整个队列中，调整传统心血管危险因素后，高血压前期与心血管事件的风险比正常血压高 45%（危险比=1.45，P=0.03）。在非老年亚组（<65 岁），高血压前期在第二个 5 年期间发生心血管事件的风险增加（危险比=2.13，P=0.01），但在老年亚组（≥65 岁）中则没有（危险比=0.93，P=0.82）（危险比差异的 P 值=0.054）。在非老年（危险比=1.60，P=0.36）或老年（危险比=1.19，P=0.63）组中，高血压前期在第一个 5 年期间的风险升高并不显著。 然而，高血压前期的风险在第一个和第二个 5 年期间没有统计学差异。
高血压前期与 10 年内发生心血管疾病的风险增加有关；一个引人关注的发现是，在非老年个体中，这种风险在前 5 年期间可能特别升高，这需要在更大的队列中得到证实。
