Coexisting prehypertension and prediabetes in healthy adults: a pathway for accelerated cardiovascular events

Abstract

High blood pressure and elevated serum glucose levels often precede adverse cardiovascular events. The cardiovascular risk in otherwise healthy US adults with prehypertension (PreHTN) and/or prediabetes (PreDM), although perceived to be high, is largely undocumented. Coexisting PreHTN and PreDM in healthy US adults, correlates with untoward alterations in the commonly recognized cardiometabolic risk factors. The study investigated disease-free US adults (n¼4,561) from the NHANES database (1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006). PreHTN and PreDM were diagnosed using JNC 7 and American Diabetes Association criteria, respectively; PreHTN was defined as systolic blood pressure 120-139 and/or diastolic blood pressure 80-89 mm Hg, and PreDM was defined as fasting blood sugar 100-125 mg dl À1 . The prevalence of coexisting PreHTN and PreDM (Co-PreHTN+PreDM) during the study period (1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006) was 11.2±0.6%. Prevalence increased with age, was higher in men, and was lowest in non-Hispanic Blacks. The mean systolic blood pressure was 126.0 ± 0.5 mm Hg, diastolic blood pressure was 75.0 ± 0.5 mm Hg and fasting blood sugar was106.3 ± 0.3 mg dl À1 . Compared to adults with normotension, normoglycemia, subjects with CoPreHTN+PreDM displayed adversely altered cardiometabolic risk factors. Healthy men and women with Co-PreHTN+PreDM were, on average, overweight with a large waist circumference, displayed an exacerbated systemic inflammation and higher insulin resistance. They had elevated triglycerides, lower high-density lipoprotein cholesterol, leading to above average cardiac risk ratios and were significantly more likely to have two or three concomitant metabolic risk factors. High prevalence of Co-PreHTN+PreDM in healthy US adults, a strong correlate for dysregulated cardiometabolic risk factors, highlights a plausible accelerated pathway for early cardiovascular events.

High prevalence of coexisting prehypertension and prediabetes among healthy adults in northern and northeastern China

“…The prevalence of co-PreHTN and PreDM was even higher in men than women, and increased with age and BMI. Our findings suggest that prevalence of co-PreHTN and PreDM in our population is similar to that observed in a recent survey conducted in a healthy US population [15]. It has been previously reported that PreDM markedly increases CVD risk in prehypertensive individuals [16].…”

Fasting glucose and HbA1c levels as risk factors for the development of hypertension in Japanese individuals: Toranomon hospital health management center study 16 (TOPICS 16)

“…34 We showed that the presence of hyperglycemia along with prehypertension, older age or overweight further increased the risk of hypertension, suggesting the importance of assessing the risk of future hypertension by also considering the glycemic status. There has been an attempt to consider multiple risk factors in predicting the development of hypertension.…”

Endothelial Dysfunction: An Early Cardiovascular Risk Marker in Asymptomatic Obese Individuals with Prediabetes

“…We have demonstrated a high prevalence of isolated prediabetes or prehypertension and co-existing prediabetes and prehypertension, among the otherwise healthy US adults (Gupta et al, 2011). We have also elucidated that asymptomatic obese adults with overly heightened systemic inflammation, tend to have prediabetes and prehypertension (Gupta et al, 2010a).…”