title: Prehypertension and the risk of coronary heart disease in Asian and Western populations: a meta-analysis.
abstract: BACKGROUND
  The results of studies on the association between prehypertension (blood pressure 120 to 139/80 to 89 mm Hg) and coronary heart disease (CHD) remain controversial. Furthermore, it is unclear whether prehypertension affects the risk of CHD in Asian and Western populations differently. This meta-analysis evaluated the risk of CHD associated with prehypertension and its different subgroups.
  
  
  RESULTS
  The PubMed and Embase databases were searched for prospective cohort studies with data on prehypertension and the risk of CHD. Studies were included if they reported multivariate-adjusted relative risks (RRs) with 95% CIs of CHD from prehypertension. A total of 591 664 participants from 17 prospective cohort studies were included. Prehypertension increased the risk of CHD (RR 1.43, 95% CI 1.26 to 1.63, P<0.001) compared with optimal blood pressure (<120/80 mm Hg). The risk of CHD was higher in Western than in Asian participants (Western: RR 1.70, 95% CI 1.49 to 1.94; Asian: RR 1.25, 95% CI 1.12 to 1.38; ratio of RRs 1.36, 95% CI 1.15 to 1.61). The population-attributable risk indicated that 8.4% of CHD in Asian participants was attributed to prehypertension, whereas this proportion was 24.1% in Western participants.
  
  
  CONCLUSIONS
  Prehypertension, even at the low range, is associated with an increased risk of CHD. This risk is more pronounced in Western than in Asian populations. These results supported the heterogeneity of target-organ damage caused by prehypertension and hypertension among different ethnicities and underscore the importance of prevention of CHD in Western patients with prehypertension.
authors.affiliation: Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China (Y.H., C.L., D.Z., J.H., J.P., D.X.).
authors.forename: Yuli
authors.initials: Y
authors.lastname: Huang
authors.affiliation: Department of Cardiology, the First People's Hospital of Shunde, Foshan, China (X.C., Y.H.).
authors.forename: Xiaoyan
authors.initials: X
authors.lastname: Cai
authors.affiliation: Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China (Y.H., C.L., D.Z., J.H., J.P., D.X.).
authors.forename: Changhua
authors.initials: C
authors.lastname: Liu
authors.affiliation: Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China (Y.H., C.L., D.Z., J.H., J.P., D.X.).
authors.forename: Dingji
authors.initials: D
authors.lastname: Zhu
authors.affiliation: Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China (Y.H., C.L., D.Z., J.H., J.P., D.X.).
authors.forename: Jinghai
authors.initials: J
authors.lastname: Hua
authors.affiliation: Department of Cardiology, the First People's Hospital of Shunde, Foshan, China (X.C., Y.H.).
authors.forename: Yunzhao
authors.initials: Y
authors.lastname: Hu
authors.affiliation: Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China (Y.H., C.L., D.Z., J.H., J.P., D.X.).
authors.forename: Jian
authors.initials: J
authors.lastname: Peng
authors.affiliation: Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China (Y.H., C.L., D.Z., J.H., J.P., D.X.).
authors.forename: Dingli
authors.initials: D
authors.lastname: Xu
mesh_terms: D044466:Asian People / Q000208:ethnology*; D001794:Blood Pressure; D003327:Coronary Disease / Q000453:epidemiology* / Q000208:ethnology*; D006801:Humans; D015994:Incidence; D058246:Prehypertension / Q000150:complications / Q000453:epidemiology*; D012306:Risk; D018570:Risk Assessment; D012307:Risk Factors; D044465:White People / Q000208:ethnology*
keywords: cardiovascular disease; coronary heart disease; prehypertension; risk