Key result
Progression to hypertension is linked to ~6% greater weight gain than persistent pre-hypertension.
Why the study?
The mechanisms underlying the frequently observed progression from pre-hypertension to hypertension are poorly understood, motivating an examination of the relationship between changes in body composition and blood pressure levels.
Cohort (n=1,145)
Over 10 years, half of pre-hypertensive individuals progress to sustained hypertension, driven largely by increases in body weight and fat mass, whereas weight and fat loss predict blood pressure normalization.
Answers are grounded in this paper and cite their sources.
Body composition changes may influence blood pressure trajectories in pre-hypertension; leaves open causal mechanisms and targeted interventions.
Objectives We studied the relationship between changes in body composition and changes in blood pressure levels. Background The mechanisms underlying the frequently observed progression from pre-hypertension to hypertension are poorly understood. Methods We examined 1,145 subjects from a population-based survey at baseline in 1994/1995 and at follow-up in 2004/2005. First, we studied individuals pre-hypertensive at baseline who, during 10 years of follow-up, either had normalized blood pressure (PreNorm, n = 48), persistently had pre-hypertension (PrePre, n = 134), or showed progression to hypertension (PreHyp, n = 183). In parallel, we studied predictors for changes in blood pressure category in individuals hypertensive at baseline (n = 429). Results After 10 years, the PreHyp group was characterized by a marked increase in body weight (+5.71% [95% confidence interval (CI): 4.60% to 6.83%]) that was largely the result of an increase in fat mass (+17.8% [95% CI: 14.5% to 21.0%]). In the PrePre group, both the increases in body weight (+1.95% [95% CI: 0.68% to 3.22%]) and fat mass (+8.09% [95% CI: 4.42% to 11.7%]) were significantly less pronounced than in the PreHyp group (p < 0.001 for both). The PreNorm group showed no significant change in body weight (-1.55% [95% CI: -3.70% to 0.61%]) and fat mass (+0.20% [95% CI: -6.13% to 6.52%], p < 0.05 for both, vs. the PrePre group). Conclusions After 10 years of follow-up, hypertension developed in 50.1% of individuals with pre-hypertension and only 6.76% went from hypertensive to pre-hypertensive blood pressure levels. An increase in body weight and fat mass was a risk factor for the development of sustained hypertension, whereas a decrease was predictive of a decrease in blood pressure.
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Markus et al. (2010) conducted a cohort in Pre-hypertension and hypertension (n=1,145). Changes in body composition (body weight and fat mass) vs. Persistent pre-hypertension (PrePre) or normalized blood pressure (PreNorm) was evaluated on Progression from pre-hypertension to hypertension and associated percent change in body weight and fat mass (95% CI 4.60% to 6.83%, p=<0.001). Increases in body weight and fat mass were greater in pre-hypertensive subjects progressing to hypertension vs persistent pre-hypertension.
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