Prognosis of Prehypertension Without Progression to Hypertension
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Even mild blood pressure (BP) elevations manifesting as prehypertension have been associated with cardiovascular disease (CVD) risk.1,2 However, this risk could be attributable to the fact that many individuals with prehypertension eventually progress to overt hypertension.2,3 The prognosis of prehypertension among individuals who never progress to hypertension and, in turn, the role of early versus late-onset prehypertension in this context remains unclear. Therefore, we conducted an investigation in the Framingham Heart Study to assess the long-term risks related to early- and late-onset prehypertension without progression to hypertension.
We used data collected from serial examinations attended by the Framingham Original (28 examinations in 1948–2005 at 2-year intervals) and Offspring (9 examinations in 1971–2014 with 4- to 8-year intervals) cohorts.4 Of all 10 333 participants, we excluded individuals who had unknown hypertension status onset age (ie, ≥55 years of age with prehypertension or hypertension present at baseline, n=788), did not attend any follow-up examinations (n=451), could not reach 60 years of age by the second-to-last examination (n=974), had not died before December 31, 2014 (n=2283; mean baseline 36.2±6.5 years of age, 57.7% women), or had missing covariates when hypertension status was ascertained (n=244). The final sample for analyses included n=5593. Three physicians adjudicated …