Is Prehypertension a Risk Factor for Cardiovascular Diseases?

Qureshi, Adnan I.; Suri, M. Fareed K.; Kirmani, Jawad F.; Divani, Afshin A.; Mohammad, Yousef

doi:10.1161/01.str.0000177495.45580.f1

Cited by 243 publications

(186 citation statements)

References 21 publications

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“…Although these values are not suggestive of hypertension, the mean baseline SBP (135 mmHg) satisfies the criteria of systolic pre-hypertension [27] that is known to increase the risk of cardiovascular diseases [28]. Our finding is in agreement with epidemiological studies [12] and supports the hypothesis of a tendency toward hypertension in RLS.…”

Section: Discussionsupporting

confidence: 88%

Is autonomic nervous system involved in restless legs syndrome during wakefulness?

et al. 2014

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A B S T R A C TObjective: To investigate cardiovascular autonomic function in patients with restless leg syndrome (RLS) by means of cardiovascular reflexes and heart rate variability (HRV) during wakefulness. Methods: Twelve RLS patients and 14 controls underwent cardiovascular function tests including headup tilt test (HUTT), Valsalva maneuver, deep breathing, hand grip, and cold face. HRV analysis was performed in the frequency domain using both autoregressive (AR) and fast Fourier transform algorithms in rest supine condition and during HUTT.Results: There was a significant increase in systolic blood pressure values in supine rest condition and a trend toward a lower Valsalva ratio in RLS patients with respect to controls. The significant and physiological changes of HRV at HUTT detected in healthy subjects were not found in RLS patients. Conclusion: RLS patients exhibit a tendency toward hypertension, reduced amplitude of both sympathetic and parasympathetic responses at HUTT, as well as blunted parasympathetic drive to blood pressure changes. These findings, if confirmed by more controlled studies, might support the hypothesis of autonomic nervous system involvement during wakefulness and consequently an enhanced cardiovascular risk in RLS.

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Section: Discussionsupporting

confidence: 88%

Is autonomic nervous system involved in restless legs syndrome during wakefulness?

et al. 2014

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“…10 This assumption is corroborated by the findings in a prospective study involving more than 5000 subjects where those with prehypertension had an increased risk of coronary heart disease and myocardial infarction which was related to SBP level but not with diastolic. 11 Another study using ABPM showed that NT subjects with endothelial dysfunction presented a higher 24-h blood pressure values, which is the reflex of consistent changes in the organisation of blood pressure circadian pattern probably related to vasopressor effects even in NT subjects. 12 There are some aspects that should be mentioned such as the impact of haemodynamic forces on arterial wall leading to damage and earlier atherosclerotic process that may be detected even in NT subjects, genetic predisposition and metabolic profile, which may individually or in association, play a role in the development of atherosclerosis.…”

Section: Discussionmentioning

confidence: 95%

Endothelial function in normotensive and high-normal hypertensive subjects

et al. 2007

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To evaluate the impact of a mild increment in blood pressure level on endothelial function, we evaluated 61 healthy volunteers (24 women, 37 men, and aged 35-50 years). All subjects underwent a blood chemistry panel to exclude any metabolic abnormalities and were submitted to a Doppler ultrasound of the brachial artery to assess endothelial function. We assessed the endothelial response to reactive hyperaemia and exogenous nitric oxide administration considering an increase in systolic blood pressure (SBP) at each 10-mm Hg interval. Our study population was divided as follows: SBP o115 mm Hg (SG1, n ¼ 13), SBP X115 mm Hg and o125 mm Hg (SG2, n ¼ 20), SBP X125 mm Hg and o135 mm Hg (SG3, n ¼ 13) and SBP X135 mm Hg and o140 mm Hg (SG4, n ¼ 15). We found a significant difference in flow-mediated dilation among SG2, SG3 and SG4, 16.275.6, 13.475.2 and 11.573.6%, Po0.05, respectively). After nitrate administration, we observed a nonsignificant decrease in brachial artery dilation among groups, P ¼ 0.217. Our data showed in a healthy normotensive population, without any risk factor for atherosclerotic disease that small increases in SBP but not in diastolic blood pressure may impair endothelial function even in subjects considered as high-normal, meaning that this population deserves more attention than usually ascribed to intervene and prevent complications, as endothelial dysfunction may represent an early change in those who develop hypertension later in life.

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“…1 The primary prevention of hypertension has been promoted to the population, particularly in adults with prehypertension (defined as systolic blood pressure (BP) of 120-139 mm Hg and/or diastolic BP of 80-89 mm Hg), 1 which is associated with an increase in cardiovascular morbidity and mortality. [2][3][4] Lifestyle modifications, including regular physical activity (PA), are the only recommended treatment for prehypertension. 1,5 The PA recommendation for the treatment of both prehypertension and hypertension includes the accumulation of 30 min or more of moderately intense PA in most, preferably all, days of the week.…”

Section: Introductionmentioning

confidence: 99%

Accumulation of physical activity: blood pressure reduction between 10-min walking sessions

2008

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The accumulation of intermittent bouts of physical activity (PA) has been found to reduce blood pressure (BP) in prehypertension and hypertension. Yet, the BP response among several short sessions within the accumulation of PA in a single day has not been examined. The purpose of the study was (1) to investigate the BP reduction during the rest periods following three successive 10-min walking sessions accumulated over a 3-h period in prehypertensive adults and (2) to observe the role of autonomic modulation during the rest periods following each short PA session. Adults with prehypertension (131.9±4.7/82.5± 6.4 mm Hg) participated in the study. BP using ambulatory monitoring and autonomic modulation through heart rate variability (HRV) using Holter monitoring were measured at baseline and during the rest periods following three short sessions (three 10-min treadmill walks at 50% of peak oxygen uptake (VO 2 peak); at least 50 min apart) over a 3-h period. Variables of BP and autonomic modulation were averaged for the baseline and for the rest periods following each 10-min walk. One-way analysis of variance with repeated measures was used to test the differences over time in BP and HRV (Po0.05). A significant main effect was found in systolic BP (P ¼ 0.039), whereas none was found in diastolic BP (P ¼ 0.630). Systolic BP was decreased following the third short session (À4.0 ± 7.4 mm Hg) compared to baseline. No significance was found in any of the autonomic modulation variables. In conclusion, accumulating intermittent bouts of PA, as short as 10 min, total 30-min walk sessions may reduce systolic BP in prehypertension.

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Is Prehypertension a Risk Factor for Cardiovascular Diseases?

Cited by 243 publications

References 21 publications

Is autonomic nervous system involved in restless legs syndrome during wakefulness?

Is autonomic nervous system involved in restless legs syndrome during wakefulness?

Endothelial function in normotensive and high-normal hypertensive subjects

Accumulation of physical activity: blood pressure reduction between 10-min walking sessions

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