Should we treat high-normal blood pressure?
OBJECTIVE
To examine the risk of cardiovascular disease associated with high-normal blood pressure in English adults and estimate the proportion of these individuals who are at high cardiovascular risk.


METHODS
Cross-sectional survey of England in 1998.


METHODS
Nationally representative sample of 12,341 individuals aged 18-80 years living in private households in England.


METHODS
Percentage of individuals with high-normal blood pressure who have cardiovascular disease, diabetes mellitus or a 10-year cardiovascular event risk of at least 20%.


RESULTS
Of the 12,341 participants, 2413 (19.6%) had high-normal blood pressure. About 5.3% of those aged 18-80 years with high-normal blood pressure had cardiovascular disease or diabetes, and a further 7.6% were at a predicted cardiovascular event risk of at least 20% over 10 years. The mean predicted risk was 8.7% for men and 6.3% for women in the high-normal blood pressure category. The majority of men aged 61-80 years were at high cardiovascular risk. On average, men and women with high-normal blood pressure had a greater incidence of cardiovascular disease and diabetes mellitus, and a greater predicted mean cardiovascular risk than those with normal blood pressure. Extending antihypertensive treatment to individuals with high-normal blood pressure who are at high cardiovascular risk would involve treating an additional 2.5% of the English population aged 18-80 years.


CONCLUSIONS
These findings support the view that individuals with high-normal blood pressure at high risk for cardiovascular disease should be targeted for blood pressure-lowering treatment.
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects* / Q000502:physiology*; D002318:Cardiovascular Diseases / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology; D003430:Cross-Sectional Studies; D003971:Diastole / Q000187:drug effects / Q000502:physiology; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015995:Prevalence; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D012737:Sex Factors; D013599:Systole / Q000187:drug effects / Q000502:physiology; D016896:Treatment Outcome
D000959:Antihypertensive Agents