Variation in Body Composition Determines Long-Term Blood Pressure Changes in Pre-Hypertension: The MONICA/KORA (Monitoring Trends and Determinants on Cardiovascular Diseases/Cooperative Research in the Region of Augsburg) Cohort Study

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• 作者：Marcello Ricardo Paulista Markus ; Jan Stritzke ; Ulrike Siewert ; Wolfgang Lieb ; Andreas Luchner ; Angela Dö ; ring ; Ulrich Keil ; Hans-Werner Hense ; Heribert Schunkert ; MONICA/KORA Investigators
• 关键词：body composition ; hypertension ; population-based study ; pre-hypertension ; risk factors
• 刊名：Journal of the American College of Cardiology
• 出版年：2010
• 出版时间：29 June 2010
• 年：2010
• 卷：56
• 期：1
• 页码：65-76
• 全文大小：1978 K

文摘

Objectives

We studied the relationship between changes in body composition and changes in blood pressure levels.

Background

The mechanisms underlying the frequently observed progression from pre-hypertension to hypertension are poorly understood.

Methods

We examined 1,145 subjects from a population-based survey at baseline in 1994/1995 and at follow-up in 2004/2005. First, we studied individuals pre-hypertensive at baseline who, during 10 years of follow-up, either had normalized blood pressure (PreNorm, n = 48), persistently had pre-hypertension (PrePre, n = 134), or showed progression to hypertension (PreHyp, n = 183). In parallel, we studied predictors for changes in blood pressure category in individuals hypertensive at baseline (n = 429).

Results

After 10 years, the PreHyp group was characterized by a marked increase in body weight (+5.71 % [95 % confidence interval (CI): 4.60 % to 6.83 % ]) that was largely the result of an increase in fat mass (+17.8 % [95 % CI: 14.5 % to 21.0 % ]). In the PrePre group, both the increases in body weight (+1.95 % [95 % CI: 0.68 % to 3.22 % ]) and fat mass (+8.09 % [95 % CI: 4.42 % to 11.7 % ]) were significantly less pronounced than in the PreHyp group (p < 0.001 for both). The PreNorm group showed no significant change in body weight (−1.55 % [95 % CI: −3.70 % to 0.61 % ]) and fat mass (+0.20 % [95 % CI: −6.13 % to 6.52 % ], p < 0.05 for both, vs. the PrePre group).

Conclusions

After 10 years of follow-up, hypertension developed in 50.1 % of individuals with pre-hypertension and only 6.76 % went from hypertensive to pre-hypertensive blood pressure levels. An increase in body weight and fat mass was a risk factor for the development of sustained hypertension, whereas a decrease was predictive of a decrease in blood pressure.