Relevância da pré-hipertensão como categoria diagnóstica em adultos assintomáticos

Abstract

Objective:To assess the association of prehypertension with metabolic, inflammatory and cardiovascular risk profile in asymptomatic individuals.Methods:Between 2006 and 2009, 11,011 asymptomatic adults (mean age: 43 years; 22% females), underwent a check-up protocol. They were divided into 3 groups: normotensive group (arterial pressure=120/80mmHg), prehypertensive group (arterial pressure >120/80mmHg and <140/90mmHg) and hypertensive group (arterial pressure≥140/90mmHg or prior diagnosis of hypertension). Each group metabolic and cardiovascular group profile was assessed.Results:The prevalence of normotension, prehypertension and hypertension was 27.9%, 53.9% and 18.2%, respectively. Prehypertensive individuals were older (mean age: 42.7 versus 40 years; p<0.001) than normotensive patients, and had higher body mass index (mean: 26.7kg/m2 versus 24kg/m2; p<0.001), higher plasma triglycerides levels (mean: 139mg/dL versus 108mg/dL; p<0.001), higher LDL-choleterol levels (mean: 128mg/dL versus 117mg/dL; p<0.001), and lower HDL-cholesterol (mean: 46.7mg/dL versus 52.7mg/dL; p<0.001). Prehypertensive individuals were more likely to have impaired fasting glucose (OR: 1.69; 95%CI: 1.39-2.04), overweight and obesity - body mass index >25kg/m2 (OR: 2.48; 95%CI: 2.24-2.74), hepatic steatosis: (OR: 2.23; 95%CI: 1.97-2.53), metabolic syndrome (OR: 3.05; 95%CI: 2.67-3.49), and high-sensitivity C-reactive protein levels>2mg/L (OR: 1.52; 95%CI: 1.35-1.71).Conclusion:Prehypertension is associated with an increased prevalence of metabolic syndrome, hepatic steatosis and subclinical inflammation.

Baseline prevalence of high blood pressure and its predictors in a rural adult population of Bangladesh: Outcome from the application of WHO PEN interventions

“…Most recent evidence using the 2017 American College of Cardiology/American Heart Association BP guideline also showed that the CVD incidence rates were higher among those with elevated BP (41.5 per 100 000 person‐years) (pre‐HTN as per JNC 7 guideline) than those with normal BP (28.6 per 100 000 person‐years) 27 . However, pre‐HTN is not globally considered as a diagnostic category as most of these healthy individuals could be stigmatized as sick and treated with unnecessary medications 28 . Nonetheless this criticism, pre‐HTN is a convergence point for several cardiovascular risk factors and an early can be valuable to track and sensitize people to adopt a healthy lifestyle 29 .…”

“…27 However, pre-HTN is not globally considered as a diagnostic category as most of these healthy individuals could be stigmatized as sick and treated with unnecessary medications. 28 Nonetheless this criticism, pre-HTN is a convergence point for several cardiovascular risk factors and an early can be valuable to track and sensitize people to adopt a healthy lifestyle. 29 Thus, it is important to control BP among the patients with pre-HTN and recognize it as a public health problem by the policymakers to mitigate the burden of HTN.…”

Fatores associados à pré-hipertensão e hipertensão arterial em trabalhadores de saúde que atuam em serviços de alta complexidade

“…Em uma investigação que objetivou caracterizar o perfil metabólico e de risco cardiovascular em população de adultos brasileiros assintomáticos, verificou-se que a pré-hipertensão esteve significativamente mais frequente em indivíduos do sexo masculino e naqueles sedentários e/ ou com excesso de peso. Tais resultados também foram encontrados em uma investigação de base populacional, realizada na cidade de Florianópolis, Santa Catarina, Brasil 36 .…”

Pré-hipertensão arterial em comunidades quilombolas do sudoeste da Bahia, Brasil

“…Essas evidências chamam atenção para um possível aumento na ocorrência de hipertensos nas comunidades quilombolas que é bastante elevado (45,4%) 12 , tendo em vista uma grande quantidade de indivíduos pré-hipertensos, que podem evoluir para a doença hipertensão arterial. Em concordância com estudos anteriores 4,33,34,37,38,39 , a prevalência da pré-hipertensão arterial foi superior positivamente em indivíduos do sexo masculino. Acredita-se que essa associação observada pode ser devido à distribuição diferencial de comportamentos de risco relacionados à saúde entre homens e mulheres.…”

“…Acredita-se que essa associação observada pode ser devido à distribuição diferencial de comportamentos de risco relacionados à saúde entre homens e mulheres. Supõe-se que indivíduos do sexo masculino apresentem as maiores prevalências de pré-hipertensão arterial pois tendem a ser expostos com mais frequência aos fatores de risco do que os do sexo feminino, principalmente aos que referem ao estilo de vida 4,39 .…”