A predictive model for risk of prehypertension and hypertension and expected benefit after population-based life-style modification (KCIS No. 24).
BACKGROUND
Few reports have identified and quantified significant risk factors responsible for multistate natural course of progression to hypertension and also regression of prehypertension to normal, which provides baseline risks to estimate the size of expected benefit derived from population-based life-style modification.


METHODS
Data used for estimating clinical parameters governing temporal natural course of hypertension are derived from 42,027 participants attending screening annually between 1999 and 2002. Information on transition history between normal, prehypertension, stage 1 and stage 2 hypertension between screens was therefore collected to compute multistep composite risk scores without intervention program. The expected benefits of risk reduction in prehypertension and hypertension under different intervention programs by modifying the related risk factors from abnormal to normal ranges were estimated.


RESULTS
The majority of risk factors play a more remarkable role in prehypertension and stage 1 hypertension but less in stage 2 hypertension. The greater the number of risk factors included in the intervention programs becomes, the lower the mean risk score is expected to achieve. The 5-year predicted cumulative risk for stage 2 hypertension decreased from 23.6% in the absence of intervention program to 14% with the provision of "six-component intervention" in men. The results were similar for women.


CONCLUSIONS
Multiple risk factors responsible for multistep transitions between prehypertension and hypertension were identified by using population-based screening data to derive multistep composite risk scores, which are useful for the expected benefit of reducing risk of hypertension by providing population-based life-style modification.
Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Chuen-Den
CD
Tseng
Amy Ming-Fang
AM
Yen
Sherry Yueh-Hsia
SY
Chiu
Li-Sheng
LS
Chen
Hsiu-Hsi
HH
Chen
Shu-Hui
SH
Chang
D000328:Adult; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D008019:Life Style; D008297:Male; D008875:Middle Aged; D008955:Models, Cardiovascular; D058246:Prehypertension / Q000453:epidemiology*; D012306:Risk; D040242:Risk Reduction Behavior