Coexisting prehypertension and prediabetes in healthy adults: a pathway for accelerated cardiovascular events
Open Access
- 13 January 2011
- journal article
- Published by Springer Science and Business Media LLC in Hypertension Research
- Vol. 34 (4), 456-461
- https://doi.org/10.1038/hr.2010.267
Abstract
High blood pressure and elevated serum glucose levels often precede adverse cardiovascular events. The cardiovascular risk in otherwise healthy US adults with prehypertension (PreHTN) and/or prediabetes (PreDM), although perceived to be high, is largely undocumented. Coexisting PreHTN and PreDM in healthy US adults, correlates with untoward alterations in the commonly recognized cardiometabolic risk factors. The study investigated disease-free US adults (n=4,561) from the NHANES database (1999-2006). PreHTN and PreDM were diagnosed using JNC 7 and American Diabetes Association criteria, respectively; PreHTN was defined as systolic blood pressure 120-139 and/or diastolic blood pressure 80-89 mm Hg, and PreDM was defined as fasting blood sugar 100-125 mg dl(-1). The prevalence of coexisting PreHTN and PreDM (Co-PreHTN+PreDM) during the study period (1999-2006) was 11.2±0.6%. Prevalence increased with age, was higher in men, and was lowest in non-Hispanic Blacks. The mean systolic blood pressure was 126.0±0.5 mm Hg, diastolic blood pressure was 75.0±0.5 mm Hg and fasting blood sugar was106.3±0.3 mg dl(-1). Compared to adults with normotension, normoglycemia, subjects with Co-PreHTN+PreDM displayed adversely altered cardiometabolic risk factors. Healthy men and women with Co-PreHTN+PreDM were, on average, overweight with a large waist circumference, displayed an exacerbated systemic inflammation and higher insulin resistance. They had elevated triglycerides, lower high-density lipoprotein cholesterol, leading to above average cardiac risk ratios and were significantly more likely to have two or three concomitant metabolic risk factors. High prevalence of Co-PreHTN+PreDM in healthy US adults, a strong correlate for dysregulated cardiometabolic risk factors, highlights a plausible accelerated pathway for early cardiovascular events.Keywords
This publication has 25 references indexed in Scilit:
- Prehypertension in disease-free adults: a marker for an adverse cardiometabolic risk profileHypertension Research, 2010
- Prediabetes and prehypertension in disease free obese adults correlate with an exacerbated systemic proinflammatory milieuJournal of Inflammation, 2010
- Association of Cardiometabolic Risk Factors and Prevalent Cardiovascular EventsMetabolic Syndrome and Related Disorders, 2009
- Cardiovascular and Metabolic Predictors of Progression of Prehypertension Into HypertensionHypertension, 2009
- Adipose Tissue Dysfunction in ObesityExperimental and Clinical Endocrinology & Diabetes, 2009
- Metabolic Syndrome and All-Cause and Cardiovascular Disease Mortality Japan Public Health Center-Based Prospective (JPHC) StudyCirculation Journal, 2009
- Role of Body Fat Distribution and the Metabolic Complications of ObesityJournal of Clinical Endocrinology & Metabolism, 2008
- Adipokines--targeting a root cause of cardiometabolic riskQJM: An International Journal of Medicine, 2008
- Predictors of progression from impaired glucose tolerance to NIDDM: an analysis of six prospective studiesDiabetes, 1997
- HDL cholesterol and other lipids in coronary heart disease. The cooperative lipoprotein phenotyping study.Cell Metabolism, 1977