Relevance of prehypertension as a diagnostic category in asymptomatic adults

OBJECTIVE To assess the association of prehypertension with metabolic, inflammatory and cardiovascular risk profile in asymptomatic individuals. METHODS Between 2006 and 2009, 11,011 asymptomatic adults (mean age: 43 years; 22% females), underwent a check-up protocol. They were divided into 3 groups: normotensive group (arterial pressure=120/80mmHg), prehypertensive group (arterial pressure >120/80mmHg and <140/90mmHg) and hypertensive group (arterial pressure>140/90mmHg or prior diagnosis of hypertension). Each group metabolic and cardiovascular group profile was assessed. RESULTS The prevalence of normotension, prehypertension and hypertension was 27.9%, 53.9% and 18.2%, respectively. Prehypertensive individuals were older (mean age: 42.7 versus 40 years; p<0.001) than normotensive patients, and had higher body mass index (mean: 26.7kg/m² versus 24kg/m²; p<0.001), higher plasma triglycerides levels (mean: 139mg/dL versus 108mg/dL; p<0.001), higher LDL-choleterol levels (mean: 128mg/dL versus 117mg/dL; p<0.001), and lower HDL-cholesterol (mean: 46.7mg/dL versus 52.7mg/dL; p<0.001). Prehypertensive individuals were more likely to have impaired fasting glucose (OR: 1.69; 95%CI: 1.39-2.04), overweight and obesity - body mass index >25kg/m² (OR: 2.48; 95%CI: 2.24-2.74), hepatic steatosis: (OR: 2.23; 95%CI: 1.97-2.53), metabolic syndrome (OR: 3.05; 95%CI: 2.67-3.49), and high-sensitivity C-reactive protein levels>2mg/L (OR: 1.52; 95%CI: 1.35-1.71). CONCLUSION Prehypertension is associated with an increased prevalence of metabolic syndrome, hepatic steatosis and subclinical inflammation.