Prospective study of predictive factors determining borderline hypertensive individuals who develop sustained hypertension: prognostic value of increased diastolic orthostatic blood pressure tilt-test response and subsequent weight gain.
Repeat hemodynamic determinations in supine and tilting positions were performed in 23 young men with borderline hypertension (HBP). The mean duration of follow-up was 48 months. During the study 11 patients had no change in hemodynamic parameters (group II), while 12 patients exhibited significant increase in systolic (p less than 0.001) and mean (p less than 0.01) arterial pressures (BP) and in body weight (p less than 0.05) (group I). In this latter group, the initial hemodynamic pattern included supine elevations in cardiac output (CO) and heart rate (HR) and significant increase in diastolic orthostatic BP. After follow-up, the group I primary supine increases in CO and HR were followed by secondary supine increases in total peripheral resistance (p less than 0.01) and systolic (p less than 0.001) and mean (p less than 0.01) BP with lower CO (p less than 0.05) and HR (p less than 0.001). In addition, it was shown during long-term follow-up in group I patients that : (1) the increase in systolic BP per unit age was negatively correlated with initial age (p less than 0.001), (2) the increase in BP was positively correlated with weight gain (p less than 0.05), and (3) the diastolic orthostatic hypertension disappeared. This study provides evidence that, in patients with borderline HBP having supine elevations of CO and HR, the subsequent development of sustained HBP can be expected, with follow-up observation of lower supine HR and disappearance of diastolic orthostatic hypertension accompanied by rapid weight gain.
D000328:Adult; D001835:Body Weight; D003971:Diastole; D006339:Heart Rate; D006801:Humans; D006973:Hypertension / Q000175:diagnosis*; D008297:Male; D009200:Myocardial Contraction; D011379:Prognosis; D011446:Prospective Studies; D013997:Time Factors; D014655:Vascular Resistance