title: 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.
abstract: 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.
authors.affiliation: Medical Clinic II, University of Lübeck Medical School, Lübeck, Germany.
authors.forename: Marcello Ricardo Paulista
authors.initials: MR
authors.lastname: Markus
authors.forename: Jan
authors.initials: J
authors.lastname: Stritzke
authors.forename: Ulrike
authors.initials: U
authors.lastname: Siewert
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Lieb
authors.forename: Andreas
authors.initials: A
authors.lastname: Luchner
authors.forename: Angela
authors.initials: A
authors.lastname: Döring
authors.forename: Ulrich
authors.initials: U
authors.lastname: Keil
authors.forename: Hans-Werner
authors.initials: HW
authors.lastname: Hense
authors.forename: Heribert
authors.initials: H
authors.lastname: Schunkert
mesh_terms: 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