title: Cardio-metabolic risk factors and prehypertension in persons without diabetes, hypertension, and cardiovascular disease.
abstract: BACKGROUND
  Prehypertension has been shown to be an early risk factor of cardiovascular disease (CVD). We investigated the prevalence and pattern of cardiometabolic risk factors in prehypertension in three ethnic Asian populations in Singapore.
  
  
  METHODS
  We examined data from Chinese (n=1177), Malay (n=774), and Indian (n=985) adults aged 40-80 years who participated in three independent population based studies conducted from 2004-2011 in Singapore who were free of diabetes, hypertension and previous CVD. Prehypertension was defined as systolic blood pressure (BP) 120-139 mm Hg or diastolic BP 80-89 mm Hg. Random blood glucose, glycated haemoglobin (HbA1c), body mass index (BMI), triglycerides, low-density lipoprotein (LDL) and high-density lipoprotein (HDL) cholesterol were examined as indicators of adverse cardiometabolic profile. The association between metabolic variables and prehypertension was examined using logistic regression models adjusting for potential confounders.
  
  
  RESULTS
  The prevalence of prehypertension was 59.8% (Chinese), 68.9% (Malays) and 57.7% Indians. Higher levels of blood glucose, HbA1c and BMI were significantly associated with prehypertension in all three ethnic groups, odds ratio (95% confidence interval) of prehypertension in Chinese, Malays and Indians were: 1.42 (1.10, 1.83), 1.53 (1.05, 2.24), 1.49 (1.13, 1.98) for high-glucose; 3.50 (1.01, 12.18), 3.72 (1.29, 10.75), 2.79 (1.31, 5.94) for high-HbA1c; 1.86 (1.34, 2.56), 2.96 (2.10, 4.18), 1.68 (1.28, 2.20) for high-BMI. In addition, higher levels of LDL cholesterol in Chinese and higher levels of triglycerides were significantly associated with prehypertension. These associations persisted when metabolic variables were analysed as continuous variables.
  
  
  CONCLUSIONS
  Higher levels of blood glucose, HbA1c and BMI were associated with prehypertension in all three ethnic groups in Singapore. Screening for prehypertension and lifestyle modifications could potentially reduce the burden of CVD in otherwise healthy Asian adults living in Singapore.
authors.forename: Peggy P C
authors.initials: PP
authors.lastname: Chiang
authors.forename: Ecosse L
authors.initials: EL
authors.lastname: Lamoureux
authors.forename: Anoop
authors.initials: A
authors.lastname: Shankar
authors.forename: E Shyong
authors.initials: ES
authors.lastname: Tai
authors.forename: Tien Y
authors.initials: TY
authors.lastname: Wong
authors.affiliation: Singapore Eye Research Institute, Singapore National Eye Centre, Level 6, 11 Third Hospital Avenue, Singapore 168751, Singapore. charumathi.sabanayagam@seri.com.sg.
authors.forename: Charumathi
authors.initials: C
authors.lastname: Sabanayagam
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D015992:Body Mass Index; D002681:China / Q000208:ethnology; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D005006:Ethnicity; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007194:India / Q000208:ethnology; D008019:Life Style; D016015:Logistic Models; D008296:Malaysia / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D058246:Prehypertension / Q000097:blood* / Q000453:epidemiology* / Q000208:ethnology; D015995:Prevalence; D012307:Risk Factors; D012846:Singapore / Q000453:epidemiology; D014280:Triglycerides / Q000097:blood
chemical_list: D001786:Blood Glucose; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D006442:Glycated Hemoglobin; D014280:Triglycerides
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