Cardiovascular events in a prehypertensive Chinese population: four-year follow-up study

Objectives: This study aimed to determine the occurrence of cardiovascular (CV) events in a prehypertensive Chinese population.

Methods: Participants meeting the JNC 7 diagnostic criteria for prehypertension (n=30,027) and ideal blood pressure (n=15,614) were enrolled in this prospective, observational cohort. New CV events were collected during follow-up of 38-53 months (mean 47.58 ± 3.19 months). A multivariate Cox proportional hazard regression model was used to analyze factors influencing CV events.

Results: Four hundred sixty-one CV events occurred during the follow-up period. Cumulative incidence rates for total CV events, cerebral infarct, cerebral hemorrhage, myocardial infarct, and deaths due to CV in the prehypertensive population were 1.19%, 0.57%, 0.20%, 0.23%, and 0.23%, respectively. These rates were higher than those of the ideal blood pressure group (0.67%, 0.27%, 0.12%, 0.17%, and 0.15% respectively). After correcting for traditional CV risk factors, relative risks (RRs) for total CV events, cerebral infarct and cerebral hemorrhages in the prehypertensive population were 1.32 (95% confidence intervals (CI): 1.06-1.65), 1.55 (95% CI: 1.10-2.18) and 1.40 (95% CI: 0.82-2.37) higher than those in the ideal blood pressure population. Compared to the ideal blood pressure group, the prehypertensive population was older, more likely male, and had higher triglycerides, total cholesterol, low-density lipoprotein cholesterol, and body mass index (p<0.05).

Conclusion: Prehypertension is an independent risk factor for total CV events and stroke.