title: Relationship of blood pressure and cardiovascular disease risk factors in normotensive middle-aged men.
abstract: We conducted this study to investigate whether subjects with high-normal systolic blood pressure (SBP) have an increased risk of cardiovascular disease (CVD) and/or diabetes compared to subjects with low-normal SBP, using metabolic syndrome (MetS) as a risk factor for future CVD/diabetes.The study included 6133 apparently healthy Taiwanese men aged 40-65 years. All subjects were normotensive, and none took medication for any abnormal MetS component. To avoid the effect of age on blood pressure, we stratified patients first by age then by SBP (that is, low, middle, and high SBP). We pooled all the low, middle, and high SBP groups from the different age strata to create 3 larger groups (Group 1, Group 2, and Group 3, respectively). The MetS components in subjects with the lowest SBP (Group 1) were compared with those in the other 2 groups. All of the MetS components, except for high-density lipoprotein cholesterol (HDL-C), were significantly lower in Group 1. Thus, it was not surprising that Group 2 and Group 3 had significantly higher odds ratios for abnormal body mass index, fasting plasma glucose, low-density lipoprotein-cholesterol (LDL-C), and triglycerides than Group 1 (but not for HDL-C). Specifically, Group 3 had a 1.7-fold higher odds ratio (p < 0.001) for having MetS than Group 1. Age, body mass index, fasting plasma glucose, LDL-C, and log triglycerides correlated significantly with SBP. In multivariate linear regression analysis, we found that only body mass index, fasting plasma glucose, and log triglycerides remained significantly related to SBP. Among them, body mass index had the highest β value.In conclusion, the level of SBP was highly correlated with body mass index, fasting plasma glucose, and triglycerides in subjects with normotension. Although there is not a cause-and-effect relationship, the risk of CVD and diabetes was significantly associated with an elevation of SBP, even when the SBP remained within the normal range. Further studies are needed to determine whether normotensive subjects would benefit from medical management.
authors.affiliation: From Department of Internal Medicine (DP, C-YW, KW, J-YW), Department of Pathology (Y-L Chen), Department of Radiology (S-HT), Department of Family Medicine (Y-L Chang, C-HH), Cardinal Tien Hospital, Fu-Jen Catholic University, Taipei; Division of Endocrinology and Metabolism, Department of Medicine (C-ZW), Shuang-Ho Hospital, Taipei Medical University, Taipei; and Division of Endocrinology and Metabolism, Department of Medicine (J-DL), Wan-Fang Hospital, Taipei Medical University, Taipei, Taiwan.
authors.forename: Dee
authors.initials: D
authors.lastname: Pei
authors.forename: Yen-Lin
authors.initials: YL
authors.lastname: Chen
authors.forename: Sai-Hung
authors.initials: SH
authors.lastname: Tang
authors.forename: Chung-Ze
authors.initials: CZ
authors.lastname: Wu
authors.forename: Jiunn-Diann
authors.initials: JD
authors.lastname: Lin
authors.forename: Yen-Ling
authors.initials: YL
authors.lastname: Chang
authors.forename: Chun-Hsien
authors.initials: CH
authors.lastname: Hsu
authors.forename: Cheng-Yi
authors.initials: CY
authors.lastname: Wang
authors.forename: Kun
authors.initials: K
authors.lastname: Wang
authors.forename: Jen-Yu
authors.initials: JY
authors.lastname: Wang
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001794:Blood Pressure / Q000502:physiology*; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D018450:Disease Progression; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology