Journal of Hypertension. 37(12):2325–2332, DECEMBER 2019
DOI: 10.1097/HJH.0000000000002191
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PMID: 31335511
Issn Print: 0263-6352
Publication Date: December 2019
Prehypertension and risk of cardiovascular diseases: a meta-analysis of 47 cohort studies
Minghui Han;Quanman Li;Leilei Liu;Dongdong Zhang;Yongcheng Ren;Yang Zhao;Dechen Liu;Feiyan Liu;Xu Chen;Cheng Cheng;Chunmei Guo;Qionggui Zhou;Gang Tian;Ranran Qie;Shengbing Huang;Xiaoyan Wu;Yu Liu;Honghui Li;Xizhuo Sun;Ming Zhang;Dongsheng Hu;
+ Author Information
aDepartment of Epidemiology and Health StatisticsbDepartment of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, HenancDepartment of Preventive Medicine, Shenzhen University School of MedicinedThe Affiliated Luohu Hospital of Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China
Abstract
To assess the association of prehypertension (SBP 120–139 mmHg and/or DBP 80–89 mmHg) and total cardiovascular diseases (CVDs), coronary heart disease (CHD), myocardial infarction (MI), and stroke.PubMed, Embase, and Web of Science were searched for articles published up to 7 November 2018. Normal range BP was considered SBP less than 120 mmHg and DBP less than 80 mmHg. RRs and 95% CIs were pooled using fixed-effects models. Meta-regression was conducted to estimate the heterogeneity among subgroups.We included 27 articles (47 studies including 491 666 study participants) in the analysis. Prehypertension was associated with total CVDs (RR 1.40, 95% CI 1.34–1.46), CHD (1.40, 1.28–1.52), MI (1.86, 1.50–2.32), and stroke (1.66, 1.56–1.76). Risk of total CVDs, MI, and stroke was increased with low-range prehypertension (low-range: SBP 120–129 mmHg and/or DBP 80–84 mmHg) versus normal BP – RR 1.42 (95% CI 1.29–1.55), 1.43 (1.10–1.86), and 1.52 (1.27–1.81), respectively – and risk of total CVDs, CHD, MI, and stroke was increased with high-range prehypertension (high-range: SBP 130–139 mmHg and/or DBP 85–89 mmHg) – RR 1.81 (95% CI 1.56–2.10), 1.65 (1.13–2.39), 1.99 (1.59–2.50), and 1.99 (1.68–2.36), respectively. The population-attributable risk for the association of total CVDs, CHD, MI, and stroke with prehypertension was 12.09, 13.26, 24.60, and 19.15%, respectively.Prehypertension, particularly high-range, is associated with increased risk of total CVDs, CHD, MI, and stroke. Effective control of prehypertension could prevent more than 10% of CVD cases.
