American College of Cardiology/American Heart Association recently updated their guidelines
for hypertension, and lowered the threshold of normal blood pressure (BP). However,
the validity of the updated guidelines remains controversial. We investigated the
relation between the revised BP classification and carotid intima-media thickness,
using a community-based cohort. We examined 1,241 subjects who underwent health check-ups
at our institute. They were divided into 3 groups based on their BP levels: normal
blood pressure (sBP <130 mm Hg and dBP <80 mm Hg, n = 556); stage 1 hypertension (130
mm Hg ≤sBP <140 mm Hg or 80 mm Hg ≤ dBP <90 mm Hg, n = 236); and stage 2 hypertension
(sBP ≥140 mm Hg or dBP ≥90 mm Hg, including subjects prescribed with antihypertensive
medications, n = 449). With an increase in BP, increase in the mean age, proportion
of males, and prevalence of CVD risk factors was seen. The prevalence of carotid plaque,
defined as intima-media thickness ≥1.1 mm, also increased with increase in BP. After
adjustment with covariates, higher BP was seen to be associated with carotid plaque
presence. Atherosclerotic changes are present in stage 1 hypertension even in the
healthy population, suggesting the importance of aggressive antihypertensive treatment
based on the updated American College of Cardiology/American Heart Association guidelines.
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Article info
Publication history
Published online: May 09, 2019
Received in revised form:
April 15,
2019
Received:
February 18,
2019
Footnotes
Conflict of interest: We have no conflict of interest for this study.
Identification
Copyright
© 2019 Elsevier Inc. All rights reserved.
