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.
OBJECTIVE
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.
Markus
Marcello Ricardo Paulista
MR
Medical Clinic II, University of Lübeck Medical School, Lübeck, Germany.
Stritzke
Jan
J
Siewert
Ulrike
U
Lieb
Wolfgang
W
Luchner
Andreas
A
Döring
Angela
A
Keil
Ulrich
U
Hense
Hans-Werner
HW
Schunkert
Heribert
H
D000273:Adipose Tissue / Q000033:anatomy & histology; D000328:Adult; D001794:Blood Pressure / Q000502:physiology*; D001823:Body Composition; D001835:Body Weight; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000503:physiopathology; D008297:Male; D008875:Middle Aged