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Abstract 130: The Prognosis of Prehypertension Without Progression to Hypertension


 Although progression from prehypertension (preHTN) to hypertension (HTN) is preventable, the prognosis of preHTN among individuals who never progress to HTN and, in turn, the role of early- versus late-onset pre-HTN in this context remains unclear. Our sample consisted of 5593 Framingham Heart Study participants (mean age 43 years, 52% women) with mortality and serial blood pressure (BP) data available. We categorized participants into 5 BP phenotypes: never preHTN or HTN; late-onset (age ≥55 years) preHTN without ever developing HTN; early-onset (age <55 years) preHTN without ever developing HTN; late-onset HTN; and early-onset HTN. Cases were considered persons who died from cardiovascular disease (CVD) or specifically from coronary heart disease (CHD), and controls included the remaining decedents. We used multivariable-adjusted regression models to estimate case-vs-control odds ratios for the 4 preHTN/HTN categories versus those who died without ever developing preHTN or HTN. The loess-smoothed curves for mean BP values, by age, for the 5 BP phenotypes are shown in
 Figure A.
 Compared to individuals who maintained optimal BP throughout life, onset of preHTN earlier or later in life, without progression to HTN, did not significantly increase odds of CVD (
 Figure B
 ) or CHD (
 Figure C
 ) death. By contrast, late- and especially early-onset HTN were associated with considerably increased odds of CVD death and CHD death. Our study findings suggest that not all forms of preHTN are associated with the same magnitude of risk for CVD death. Further investigations are needed to determine whether interventions aimed at preventing the progression from preHTN to HTN could improve outcomes.
 
 
 
