Predictors for arterial hypertension in middle aged adults

Type of funding sources: None.

Subclinical atherosclerosis is a marker for development of future atherosclerotic cardiovascular disease. However, it is still unclear whether subclinical atherosclerosis predicts hypertension in patients who have not diagnosed it yet. Aim of the study was to evaluate possible significance of subclinical atherosclerosis for the development of hypertension in patients who have not diagnosed hypertension yet.

418 middle aged adults who had subclinical atherosclerosis and without hypertension enrolled in this study (aged 31-49 years, mean age 39.12±12.0 years, male=53%). All participants were examined general clinical, anthropometric, laboratory and instrumental measures. Subclinical atherosclerosis were diagnosed using ultrasound methods via ankle-brachial index (ABI) using established cutoffs. All patients followed up to 6 years. Mean follow up was 4.5±2.1 years. All statistical analysis were performed using STATA software.

During the mean follow up period 17% (71) patients were diagnosed hypertension (SPB<140 mmHg and/or DBP<90 mmHg). Among them 12% (50) were males whilst 5 % (21) were females and men tended to have more levels of blood pressure than women did (P<0.05). During the follow up period, subclinical atherosclerosis level has increased more than 20% to those who was diagnosed hypertension. Patients who developed hypertension tended to have more smokers (OR 1.58, 1.14-2.28, CI 95%, P<0.05), BMI<30 kg/m2 (OR 1.57, 1.12-1.98, CI 95%, P<0.05), family history of hypertension (OR 1.45, 1.09-1.87, CI 95%, P<0.05), frequent stress at work (OR 1.35, 1.06-1.82, CI 95%, P<0.05) and financial problems at home (OR 1.23, 1.05-1.72, CI 95%, P<0.05).

Subclinical atherosclerosis is a predictor for new onset hypertension in men especially for those who were smoker, obese and had family history of hypertension as well as frequent stressed at work.