High-normal blood pressure and future risks a new concern for clinicians?

Abstract

The fact that hypertension (>140/ > 90 mmHg) is a well established cardiovascular risk factor in numerous studies has led epidemiologists to expand their interest also to the risks associated with high-normal blood pressure (130–139/85–89 mmHg). As blood pressure is documented to show properties of tracking over time,1 it is no wonder that people in the high-normal range tend to develop established hypertension after a follow-up period more frequently than subjects with a normal (120–129/80–84 mmHg) or even optimal (<120/ < 80 mmHg) blood pressure. Furthermore, as blood pressure is most often a part of a cardiovascular risk factor syndrome, whether called metabolic syndrome or even cardiometabolic syndrome,2 it is reasonable to believe that the tracking phenomenon could also influence other long-term risks, e.g. for type 2 diabetes and cardiovascular disease. In two recent publications from the Women's Health Study of 38 172 health professionals followed for 10.2 years,3,4 it has now been shown that subjects in the high-normal blood pressure range run an increased risk of type 2 diabetes3 as well as established hypertension and cardiovascular disease,4 when compared with other women in the normal or optimal blood pressure range at baseline. The risk is, however, less pronounced than in established hypertension. This indicates that the screening of subjects for a high-normal blood pressure could result in the … *Corresponding author. Tel: +46 40 33 24 15; fax: +46 40 92 32 72. E-mail address: Peter.Nilsson{at}med.lu.se