WESTPORT, CT (Reuters Health) – Adults with high-normal blood pressure (BP) often develop hypertension over a period of 4 years or less, investigators report in the November 17th issue of The Lancet. In fact, nearly half of adults, 65 years of age and older, with high-normal BP developed hypertension within this time frame, according to data from the Framingham Heart Study.
Dr. Ramachandran S. Vasan, from Boston University, and colleagues analyzed the BP trends of 4200 men and 5645 women who participated in the Framingham Heart Study. The subjects attended clinic examinations between 1978 and 1994. Optimum, normal, and high-normal BP were defined as lower than 120/80 mm Hg, 120-129/80-84 mm Hg, and 130-139/85-89 mm Hg, respectively. Hypertension was defined as 140/90 mm Hg or greater.
Over a 4-year period, 5.3%, 17.6%, and 37.3% of participants younger than 65 years with optimum, normal, and high-normal BP, respectively, developed hypertension. The same distribution for patients over 65 years was 16%, 25.5%, and 49.5%.
The likelihood of developing hypertension was increased an additional 20% to 30% for subjects who experienced a 5% weight gain on follow-up, the researchers note.
Annual BP screening is probably appropriate for people with high-normal BPs, as a substantial proportion do develop hypertension over a 1-year period, the authors state. Biannual screening is probably indicated for people with normal BPs and less frequent screening is likely to be adequate for people with optimum BPs.
Weight control is of prime importance for all groups, the investigators emphasize.
Lancet 2001;358:1682-1686.
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