WHEN NOT TO NEGOTIATE RHYMES WITH TAKING RISKS

Abstract

Objective: The ESH/ESC 2018 guidelines recommend lifestyle modifications in subjects with high-normal blood pressure (BP) values and low-moderate cardiovascular risk. The purpose of this study was to assess whether a population of subjects with high-normal BP could develop arterial hypertension or organ damage over a three-year follow-up. Design and method: In this study, 98 subjects (60 M), with mean age 42 ± 12.7 years, were randomized. In 34 subjects, silent signs of organ damage were highlighted, in the remaining 64 no anomalies were highlighted. ABPM (Ambulatory Blood Pressure Monitoring) was applied to the 64 subjects and, repeated annually. Results: Twelve of the 64 subjects, during the 3 years of follow up, became hypertensive grade 1, with no evidence of organ damage; 15 presented echography changes (rhythm disturbances, left anterior hemiblock, left axial deviation, left ventricular hypertrophy); 2 paroxysmal AF and only 1 subject, was subjected to tomography computerized investigations with evidence of adrenal adenoma. The remaining 34 subjects, with only lifestyle changes, presented, BP values controlled both by clinical measurement and by ABPM. Conclusions: Our results, in a small sample, show an evolution of high-normal BP in arterial hypertension grade 1, as well as the appearance of organ damage. The follow up of subjects with high-normal BP, must be constant over time, with visits, also carried out by dedicated nursing staff. In addition, a complete initial assessment would be desirable, for the exclusion of concomitant pathologies.