Prehypertension poses heightened risk of major adverse cardiovascular events

Prehypertensive individuals are at high risk of major adverse cardiovascular events (MACE), cardiovascular disease (CVD) mortality and stroke, as reported in a study.

Researchers followed a cohort of 38,765 adults aged ≥35 years, among whom 7,366 had normal BP, 18,095 had prehypertension, and 13,304 had hypertension. Over a median follow-up period of 12.5 years, 3,958 individuals developed MACE, including 1,982 CVD deaths, 3,030 strokes and 648 myocardial infarction.

The age and sex-adjusted incidence of MACE and its subtypes progressively increased with blood pressure (BP) level elevation. Incidence rates per 100,000 person-years were 478.8 among participants with normal BP, 628.2 among those with prehypertension, and 1,107.3 among those with hypertension; the difference between prehypertension and normal BP was significant (p<0.001).

Multivariable Cox proportional hazards analysis revealed that compared with normal BP, prehypertension contributed to significant increases in the risks of incident MACE (hazard ratio [HR], 1.337, 95 percent confidence interval [CI], 1.186–1.508; p<0.001), CVD mortality (HR, 1.331, 95 percent CI, 1.109–1.597; p=0.002) and stroke (HR, 1.424, 95 percent CI, 1.237–1.639; p<0.001) but not myocardial infarction (p>0.05).

The present data underscore the important role that prehypertension plays in MACE, researchers said, emphasizing the urgent need for BP monitoring and early intervention in prehypertensive individuals.