High-normal Blood Pressure Group Research Articles

High-normal blood pressure is associated with increased resting sympathetic activity but normal responses to stress tests

Objective. High-normal blood pressure (BP) increases the risk of cardiovascular (CV) disease. The mechanisms underlying this increased risk are not clear. Sympathetic activation appears to be a potential mechanism linking high-normal BP to CV disease. This study examined whether high-normal BP compared with optimal BP is linked to sympathoexcitation at rest and/or during laboratory stressors. Methods. Heart rate (HR), BP and muscle sympathetic nerve activity (MSNA) were obtained at rest and during stress tests (sustained handgrip and mental stress) in 18 subjects (15 males and three females) with high-normal BP (systolic BP of 130–139 mmHg, diastolic BP of 85–89 mmHg, or both) and in 12 subjects (10 males and two females) with optimal BP (< 120/80 mmHg) matched for age (34 ± 3 years in both groups) and body mass index (25 ± 2 kg/m2 in both groups). Results. Despite the higher resting BP levels, MSNA was higher in subjects with high-normal BP than in the optimal BP group (26 ± 3 vs 18 ± 2 bursts/min, p< 0.05). During sustained handgrip, MSNA increased by 37 ± 14% in high-normal BP group compared with an increase of 49 ± 15% in optimal BP group (p = 0.55). Changes during mental stress were 50 ± 28% and 37 ± 12%, respectively (p = 0.73). There were no significant differences in SBP responses to handgrip and mental stress between the high-normal and optimal BP groups. Baseline HR and chronotropic responses to stress tests were comparable between the two groups. Conclusion. In comparison with optimal BP, high-normal BP is associated with increased resting MSNA, but normal neural and circulatory responses to stress tests. These findings suggest that tonic activation of the sympathetic nervous system may precede overt arterial hypertension and contribute to an excess risk of CV disease in subjects with high-normal BP.

High normal blood pressure is an independent risk factor for cardiovascular disease among middle-aged but not in elderly populations: 9-year results of a population-based study

Data are conflicting and sparse regarding the impact of high normal blood pressure (BP) (systolic BP (SBP) of 130-139 mm Hg or diastolic BP (DBP) of 85-89 mm Hg) on incident cardiovascular disease (CVD) among middle-aged vs elderly population. We examined the risk of BP categories among 6273 participants ≥ 30 years, free of CVD at baseline, during more than 9.3 years follow-up. Cox regression analysis was used to estimate the hazard ratio (HR) of CVD for normal BP group (SBP between 120-129 mmHg or DBP between 80-85 mmHg), high normal BP group and hypertension group (SBP ≥ 140 mm Hg or DBP ≥ 90 mmHg or taking antihypertensive drugs), considering those with optimal BP (SBP<120 mmHg and DBP<80 mmHg) as reference. During follow-up, 512 CVD events occurred. There was significant interaction between age and BP categories (P=0.028) in prediction of CVD. In multivariate analysis, HRs (95% CIs) of CVD were 1.62 (1.11-2.37) and 2.20 (1.57-3.09) for middle aged with high normal and hypertensive BP groups, respectively. Among elderly (≥ 60 years), HR was 2.09 (1.36-3.21) only for hypertensive ones. High normal BP is a risk factor for incident of CVD only among middle-aged population. Furthermore, the effect of hypertension on incident CVD was stronger among younger population.

The evaluation of arterial early damage in high-normal blood pressure population

Background and objectiveHypertension is a major risk factor of cardiovascular and cerebrovascular diseases, but range of subjects whose blood pressure are just lower than the cut point of hypertension has...

Analysis on vascular risk factors accompanied with high-normal blood pressure among Uygur, Kazak, Mongolian and Han populations in Boertala region of Xinjiang, China.

To study the prevalence and distribution of high-normal blood pressure (BP) and the prevalence rates of risk factors related to cardiovascular diseases (CVD) among Uygur, Kazak, Mongolian and Han populations in Boertala Mongol Autonomous Prefecture of Xinjiang. 4325 Subjects, with numbers of Uygur, Kazak, Mongolian, Han ethnicities as 1247, 1047, 817, 1214 cases, respectively and aged 20 - 79 years, were selected from the cross-sectional study on hypertension in Boertala Mongol Autonomous Prefecture of Xinjiang. The prevalence rates of related risk factors on CVD were analyzed among multiethnic populations with high-normal BP. (1) The prevalence rates of high-normal BP were 39.2%, 34.5%, 36.0%, 36.5% respectively in Uygur, Kazak, Mongolian, Han populations. The prevalence rate of aged < 40 years in Uygur, Kazak, Mongolian was higher than that of aged 40 - 60 (P = 0.000, 0.006, 0.016 respectively in Uygur, Kazak, Mongolian) and > 60 years (all the P = 0.000 in the three ethnic populations) in the same ethnic population. (2) In the high-normal BP groups, subjects with both SBP (120 - 139 mm Hg) and DBP (80 - 89 mm Hg) at high-normal BP level accounted for the majority (> 45%) while subjects with only DBP (80 - 89 mm Hg) at high-normal BP level had the lowest prevalence rate (> 13%). (3) The prevalence rates of overweight-obesity (body mass index >/= 24.0 kg/m(2)), visceral obesity (waist circumference >/= male 85 cm/female 80 cm), dyslipidemia and >/= 1 risk factors of CVD in multiethnic populations respectively were >/= 57%, 62%, 43% and 82%. (4) Analyzed by multiple regression, aging, over-weight and or obesity, being male etc. were risk factors for high-normal BP. High-normal blood pressure was common among aged 20 - 79 years Uygur, Kazak, Mongolian, Han populations, especially among people < 40 years, in Xinjiang Boertala region, which was often accompanied by others risk factors of cardiovascular disease. Prevention and control programs on risk factors for population with high-normal blood pressure need to be strongly advocated.

Ambulatory monitoring predicts development of drug‐treated hypertension in subjects with high normal blood pressure

Background: High normal blood pressure (HNBP), i.e. blood pressure (BP) ≥ 130/85 mmHg and <140/90 mmHg, is an important predictor of progression to established hypertension. Design: The purpose of this retrospective study was the evaluation of the predictive value of ambulatory blood pressure monitoring (ABPM) for the development of drug‐treated hypertension in subjects with HNBP and other risk factors. Methods: We studied 127 subjects (69 M, 58 F, age 50 ± 14 years): 59 subjects had normal BP (NBP: <130/85 mmHg), 68 subjects had systolic and/or diastolic HNBP. All the subjects underwent ABPM. There were 21/68 (30.9%) subjects in the HNBP group vs. 1/59 (1.7%) in the NBP group with an elevated (>135/85 mmHg) daytime ambulatory blood pressure (ABP) (p < 0.01). Results: After an average follow‐up of 103 ± 28 months, 27 subjects (39.7%) in the HNBP group and 4 subjects (6.8%) in the NBP group developed drug‐treated hypertension (p < 0.01). An elevated daytime ABP correctly predicted development of drug‐treated hypertension in 17/21 subjects (81%) of the HNBP group and in the only subject of the NBP group. Development of drug‐treated hypertension was associated with higher office and ambulatory BP (p < 0.01) and pulse pressures (p < 0.05), longer follow‐up (p < 0.05) and higher prevalence of hypercholesterolaemia and smoking (p < 0.01). Conclusions: We conclude that ABPM correctly predicts development of drug‐treated hypertension in most subjects who were identified early as having a daytime mean ABP >135/85 mmHg. ABPM appears to be a useful clinical tool in the early diagnosis of hypertension in subjects with metabolic risk factors and smoking.