title: Prehypertension and incidence of cardiovascular disease: a meta-analysis.
abstract: BACKGROUND
  Prospective cohort studies of prehypertension and the incidence of cardiovascular disease (CVD) are controversial after adjusting for other cardiovascular risk factors. This meta-analysis evaluated the association between prehypertension and CVD morbidity.
  
  
  METHODS
  Databases (PubMed, EMBASE and the Cochrane Library) and conference proceedings were searched for prospective cohort studies with data on prehypertension and cardiovascular morbidity. Two independent reviewers assessed the reports and extracted data. The relative risks (RRs) of CVD, coronary heart disease (CHD) and stroke morbidity were calculated and reported with 95% confidence intervals (95% CIs). Subgroup analyses were conducted on blood pressure, age, gender, ethnicity, follow-up duration, number of participants and study quality.
  
  
  RESULTS
  Pooled data included the results from 468,561 participants from 18 prospective cohort studies. Prehypertension elevated the risks of CVD (RR = 1.55; 95% CI = 1.41 to 1.71); CHD (RR = 1.50; 95% CI = 1.30 to 1.74); and stroke (RR = 1.71; 95% CI = 1.55 to 1.89). In the subgroup analyses, even for low-range prehypertension, the risk of CVD was significantly higher than for optimal BP (RR = 1.46, 95% CI = 1.32 to 1.62), and further increased with high-range prehypertension (RR = 1.80, 95% CI = 1.41 to 2.31). The relative risk was significantly higher in the high-range prehypertensive populations than in the low-range populations (χ2= 5.69, P = 0.02). There were no significant differences among the other subgroup analyses (P>0.05).
  
  
  CONCLUSIONS
  Prehypertension, even in the low range, elevates the risk of CVD after adjusting for multiple cardiovascular risk factors.
authors.affiliation: Department of Cardiology, Nanfang Hospital, Southern Medical University, 1838 North Guangzhou Avenue, Guangzhou 510515, China.
authors.forename: Yuli
authors.initials: Y
authors.lastname: Huang
authors.forename: Sheng
authors.initials: S
authors.lastname: Wang
authors.forename: Xiaoyan
authors.initials: X
authors.lastname: Cai
authors.forename: Weiyi
authors.initials: W
authors.lastname: Mai
authors.forename: Yunzhao
authors.initials: Y
authors.lastname: Hu
authors.forename: Hongfeng
authors.initials: H
authors.lastname: Tang
authors.forename: Dingli
authors.initials: D
authors.lastname: Xu
mesh_terms: D001794:Blood Pressure / Q000502:physiology; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000453:epidemiology* / Q000503:physiopathology; D015331:Cohort Studies; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D015994:Incidence; D058246:Prehypertension / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D011446:Prospective Studies
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