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Volume 345:1291-1297 November 1, 2001 Number 18 Next

	Full Text PDF Editorial by Panza, J. A. Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

ABSTRACT

Background Information is limited regarding the risk of cardiovascular disease in persons with high-normal blood pressure (systolic pressure of 130 to 139 mm Hg, diastolic pressure of 85 to 89 mm Hg, or both).

Methods We investigated the association between blood-pressure category at base line and the incidence of cardiovascular disease on follow-up among 6859 participants in the Framingham Heart Study who were initially free of hypertension and cardiovascular disease.

Results A stepwise increase in cardiovascular event rates was noted in persons with higher base-line blood-pressure categories. The 10-year cumulative incidence of cardiovascular disease in subjects 35 to 64 years of age who had high-normal blood pressure was 4 percent (95 percent confidence interval, 2 to 5 percent) for women and 8 percent (95 percent confidence interval, 6 to 10 percent) for men; in older subjects (those 65 to 90 years old), the incidence was 18 percent (95 percent confidence interval, 12 to 23 percent) for women and 25 percent (95 percent confidence interval, 17 to 34 percent) for men. As compared with optimal blood pressure, high-normal blood pressure was associated with a risk-factor–adjusted hazard ratio for cardiovascular disease of 2.5 (95 percent confidence interval, 1.6 to 4.1) in women and 1.6 (95 percent confidence interval, 1.1 to 2.2) in men.

Conclusions High-normal blood pressure is associated with an increased risk of cardiovascular disease. Our findings emphasize the need to determine whether lowering high-normal blood pressure can reduce the risk of cardiovascular disease.

Source Information

From the Framingham Heart Study, Framingham, Mass. (R.S.V., M.G.L., E.P.L., J.C.E., C.J.O., D.L.); the Cardiology Section (R.S.V.) and the Department of Preventive Medicine and Epidemiology (R.S.V., M.G.L., J.C.E., W.B.K., D.L.), Boston University School of Medicine, Boston; the Division of Cardiology, Massachusetts General Hospital and Harvard Medical School, Boston (C.J.O.); the Divisions of Cardiology and Clinical Epidemiology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston (D.L.); and the National Heart, Lung, and Blood Institute, Bethesda, Md. (C.J.O., D.L.).

Address reprint requests to Dr. Vasan at the Framingham Heart Study, 5 Thurber St., Framingham, MA 01702, or at vasan{at}fram.nhlbi.nih.gov.

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