Abstract
Background.Prevention of pre-hypertension is an important goal for primary care patients. Obesity is a risk factor for hypertension, but has not been addressed for pre-hypertension in primary care populations. The objective of this study was to assess the degree to which obesity independently is associated with risk for pre-hypertension in family medicine patients.Methods.This study was a retrospective analysis of information abstracted from medical records of 707 adult patients. Multivariable logistic regression was used to test the relationship between body mass index (BMI) and pre-hypertension, after adjustment for comorbidity and demographic characteristics. Pre-hypertension was defined as systolic pressure between 120 and 139 mm Hg or diastolic pressure between 80 and 89 mm Hg.Results.In our sample, 42.9% of patients were pre-hypertensive. Logistic regression analysis revealed that, in comparison to patients with normal body mass, patients with BMI > 35 had higher adjusted odds of being pre-hypertensive (OR = 4.5, CI 2.55–8.11, p < .01). BMI between 30 and 35 also was significant (OR = 2.7, CI 1.61–4.63, p < 0.01) as was overweight (OR = 1.8, CI 1.14–2.92, p = 0.01).Conclusion.In our sample of family medicine patients, elevated BMI is a risk factor for pre-hypertension, especially BMI > 35. This relationship appears to be independent of age, gender, marital status and comorbidity. Weight loss intervention for obese patients, including patient education or referral to weight loss programs, might be effective for prevention of pre-hypertension and thus should be considered as a potential quality indicator.
Highlights
Prevention of pre-hypertension is an important goal for primary care patients
Since the aging of the population is expected to increase the prevalence of chronic diseases in the population, creating strains on the medical care system, modifications of clinical practice that are designed to reduce risk factors are of increasing importance[5]
Since the JNC 7 reclassification of hypertension into normal, pre-hypertension and hypertension stages 1 and 2, more attention has been paid to patients with blood pressure above optimal but previously considered to be normal
Summary
Prevention of pre-hypertension is an important goal for primary care patients. It is related to pain arising from arthritis, migraine progression, orthopedic disorders and general pain[2,3,4]. It may be a risk factor for borderline conditions such as pre-hypertension. The relevance of weight loss interventions as quality indicators has not been explored. This is an interesting omission, since action to encourage another type of behavior change, smoking cessation, is regarded as good medical care
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