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ANNUAL SCREENING RECOMMENDED FOR PEOPLE WITH HIGH-NORMAL BLOOD PRESSURE (pp 1659, 1682)
November 14, 2001A study in this week's issue of THE LANCET highlights how people with normal or high-normal (slightly raised, but not high) blood pressure can progress to high blood pressure (hypertension) over a four-year period, which is positively associated with advancing age and weight increase. Authors of the study suggest that blood pressure should be monitored every year for people with high-normal blood pressure, and possibly every two years for people with normal blood pressure.
Patients with optimum (less than 120/80 mm Hg), normal (120-129/80-84 mm Hg), and high normal (130-139/85-89 mm Hg) blood pressure (BP) may progress to high blood pressure (hypertension, 140/90 mm Hg or greater) over time. Ramachandran Vasan and colleagues from the Framingham Heart Study Group, USA, aimed to establish the best frequency of BP screening by assessing the rates and determinants of progression to high blood pressure.
The investigators assessed repeated BP measurements in individuals who did not have high blood pressure (BP less than 140/90 mm Hg) from the Framingham Study (which totalled 4200 men and 5645 women). The average age of the participants was 52 years of age, and BP examination was done between 1978 and 1994. The incidence of high blood pressure (or use of antihypertensive treatment) and its determinants were studied.
Around 5% of participants with optimum BP, 18% with normal, and 37% with high normal BP aged below 65 years progressed to high blood pressure over 4 years. Corresponding four-year rates of progression for patients 65 years and older were 16%, 26%, and 50%, respectively. Obesity and weight gain also contributed to progression; a 5% weight gain on follow-up was associated with 20-30% increased odds of hypertension.
In an accompanying Commentary (p 1659), Sven-Olof Isacsson from the University of Lund, Sweden, states: "The key features that influence a rise in blood pressure are still not completely known. [Future] research should focus on mechanisms involved in the increase of blood pressure and the transition to hypertension. Identifying specific pathways, and susceptible subgroups of people, would also provide new opportunities for intervention. Research also has to address the major issue of how new insights from research are used to achieve effects in the population involving all sectors of the society. Other topics for attention include prevention of unhealthy lifestyles in childhood and adolescence, the role of physical activity in the prevention of high blood pressure and the maintenance of normal body weight, and strategies for the incorporation of preventive activities in primary care practice."
Contact: Dr Ramachandran S Vasan, c/o NHLBI Communications Office, Room 4A21/Building 31, 31 Center Street, MSC 2480, Bethesda, Maryland 20892-2480 USA; T) +1 301 496 4236; F) +1 301 402 2405; E) vasan@fram.nhlbi.nih.gov
Professor Sven-Olof Isacsson, Department of Community Medicine, Samh'¤llsmedicinska institutionen, University of Lund, 20502 Malmo, Sweden; T) +46 40 332661; E) Sven-Olof.Isacsson@smi.mas.lu.se
Lancet
Around 5% of participants with optimum BP, 18% with normal, and 37% with high normal BP aged below 65 years progressed to high blood pressure over 4 years. Corresponding four-year rates of progression for patients 65 years and older were 16%, 26%, and 50%, respectively. Obesity and weight gain also contributed to progression; a 5% weight gain on follow-up was associated with 20-30% increased odds of hypertension.
In an accompanying Commentary (p 1659), Sven-Olof Isacsson from the University of Lund, Sweden, states: "The key features that influence a rise in blood pressure are still not completely known. [Future] research should focus on mechanisms involved in the increase of blood pressure and the transition to hypertension. Identifying specific pathways, and susceptible subgroups of people, would also provide new opportunities for intervention. Research also has to address the major issue of how new insights from research are used to achieve effects in the population involving all sectors of the society. Other topics for attention include prevention of unhealthy lifestyles in childhood and adolescence, the role of physical activity in the prevention of high blood pressure and the maintenance of normal body weight, and strategies for the incorporation of preventive activities in primary care practice."
Contact: Dr Ramachandran S Vasan, c/o NHLBI Communications Office, Room 4A21/Building 31, 31 Center Street, MSC 2480, Bethesda, Maryland 20892-2480 USA; T) +1 301 496 4236; F) +1 301 402 2405; E) vasan@fram.nhlbi.nih.gov
Professor Sven-Olof Isacsson, Department of Community Medicine, Samh'¤llsmedicinska institutionen, University of Lund, 20502 Malmo, Sweden; T) +46 40 332661; E) Sven-Olof.Isacsson@smi.mas.lu.se
Lancet
Hypertension Current Events and Hypertension News RSSFeeling lonely adds to rate of blood pressure increase in people 50 years old and older
Chronic feelings of loneliness take a toll on blood pressure over time, causing a marked increase after four years, according to a new study at the University of Chicago.
Mount Sinai researchers are the first to identify heart abnormalities in World Trade Center workers
Researchers from Mount Sinai School of Medicine are presenting more than 20 ground-breaking studies at the American College of Cardiology (ACC) 59th annual scientific session (ACC.10) in Atlanta.
UF researcher urges caution in reducing blood pressure in patients with diabetes, coronary disease
For patients with diabetes and heart disease, less isn't always more - at least when it comes to blood pressure.
Study results leave search for new diabetes and heart disease treatments unresolved
Treatment with the anti-hypertensive drug valsartan (Diovan) led to a modest reduction in the development of type 2 diabetes but did not significantly reduce cardiovascular events in patients with impaired glucose tolerance, according to researchers at Duke University Medical Center and the University of Oxford.
OHSU team discovers powerful molecule regulator in blood pressure control system
Researchers at Oregon Health & Science University's School of Dentistry (www.ohsu.edu/sod) have discovered that nitric oxide is a powerful regulator of a molecule that plays a critical role in the development and function of the nervous system.
Study: Kidney disease a big risk for younger, low-income minorities
Chronic kidney disease (CKD) afflicts a large number of younger minority adults receiving medical care in settings that serve the uninsured and underinsured (settings collectively known as the healthcare safety net).
'Improved doctor-pharmacist collaboration needed': study
A research team from the Laval Centre de santé et de services sociaux, Université de Montréal and McGill University Health Centre has examined the benefits of greater collaboration between family physicians and community pharmacists for select patients.
Poll reveals sleep differences among ethnic groups
The 2010 Sleep in America poll released today by the National Sleep Foundation (NSF) reveals significant differences in the sleep habits and attitudes of Asians, Blacks/African-Americans, Hispanics and Whites. It is the first poll to examine sleep among these four ethnic groups.
Anti-hypertensive drugs to enhance esophageal contraction
Nifedipine, a calcium-channel blocker, was shown to decrease lower esophageal sphincter pressure and increase esophageal acid exposure time, while atenolol, a b1 blocker, was shown to inhibit relaxation of the smooth muscle of the esophagus.
How to evaluate hemodynamics of gastric varices effectively?
Gastric varices (GV) are an important complication of portal hypertension. As an almost atraumatic method, computed tomography (CT) angiography has been used widely to show the portal vein system.
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