Cardio-metabolic risk factors and prehypertension in persons without diabetes, hypertension, and cardiovascular disease

Peggy Pc Chiang,E Shyong Tai,Anoop Shankar,Tien Y Wong,Ecosse L Lamoureux,Charumathi Sabanayagam

doi:10.1186/1471-2458-13-730

Abstract

BackgroundPrehypertension has been shown to be an early risk factor of cardiovascular disease (CVD). We investigated the prevalence and pattern of cardiometabolic risk factors in prehypertension in three ethnic Asian populations in Singapore.MethodsWe examined data from Chinese (n = 1177), Malay (n = 774), and Indian (n = 985) adults aged 40–80 years who participated in three independent population based studies conducted from 2004–2011 in Singapore who were free of diabetes, hypertension and previous CVD. Prehypertension was defined as systolic blood pressure (BP) 120–139 mm Hg or diastolic BP 80–89 mm Hg. Random blood glucose, glycated haemoglobin (HbA1c), body mass index (BMI), triglycerides, low-density lipoprotein (LDL) and high-density lipoprotein (HDL) cholesterol were examined as indicators of adverse cardiometabolic profile. The association between metabolic variables and prehypertension was examined using logistic regression models adjusting for potential confounders.ResultsThe prevalence of prehypertension was 59.8% (Chinese), 68.9% (Malays) and 57.7% Indians. Higher levels of blood glucose, HbA1c and BMI were significantly associated with prehypertension in all three ethnic groups, odds ratio (95% confidence interval) of prehypertension in Chinese, Malays and Indians were: 1.42 (1.10, 1.83), 1.53 (1.05, 2.24), 1.49 (1.13, 1.98) for high-glucose; 3.50 (1.01, 12.18), 3.72 (1.29, 10.75), 2.79 (1.31, 5.94) for high-HbA1c; 1.86 (1.34, 2.56), 2.96 (2.10, 4.18), 1.68 (1.28, 2.20) for high-BMI. In addition, higher levels of LDL cholesterol in Chinese and higher levels of triglycerides were significantly associated with prehypertension. These associations persisted when metabolic variables were analysed as continuous variables.ConclusionsHigher levels of blood glucose, HbA1c and BMI were associated with prehypertension in all three ethnic groups in Singapore. Screening for prehypertension and lifestyle modifications could potentially reduce the burden of CVD in otherwise healthy Asian adults living in Singapore.

Highlights

Prehypertension has been shown to be an early risk factor of cardiovascular disease (CVD)
We examined the association between cardiometabolic risk factors and prehypertension in an apparently healthy multi-ethnic Singaporeans without diabetes mellitus, hypertension and preexisting CVD
Participants with prehypertension within each ethnic group presented with higher levels of triglycerides, blood glucose, and HbA1c

Summary

Introduction

Prehypertension has been shown to be an early risk factor of cardiovascular disease (CVD). We investigated the prevalence and pattern of cardiometabolic risk factors in prehypertension in three ethnic Asian populations in Singapore. To date no study has examined the association of cardiometabolic risk factors with prehypertension in Asia This information is important because the prevalence of CVD is high among Asians and the contribution of major risk factors to CVD [8,9] and diabetes [10] have been shown to be different among Asians compared to Western populations. By further studying these associations separately among major Asian ethnic groups, a better understanding of the contribution of the key cardiometabolic factors to prehypertension in different ethnic groups can be more clearly elucidated. Examining the contribution of both cardiometabolic and non-cardiometabolic factors to prehypertension in different ethnic groups may better inform about the pathogenesis of prehypertension and intervention programs aimed at preventing and stemming the progression of cardiac or metabolic illnesses

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Results

Conclusion