| Authors | Franklin SS, Pio JR, Wong ND, Larson MG, Leip EP, Vasan RS, Levy D | |
| Title | Predictors of new-onset diastolic and systolic hypertension: the Framingham Heart Study | |
| Full source | Circulation. 2005 Mar 8;111(9):1121-7. Epub 2005 Feb 21 | |
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 Per scorrere le diapositive |
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| Abstract | BACKGROUND:
Factors leading differentially to the development of isolated diastolic
(IDH), systolic-diastolic (SDH), and isolated systolic (ISH) hypertension
are poorly understood. We examined the relations of blood pressure (BP)
and clinical risk factors to the new onset of the 3 forms of hypertension.
METHODS AND RESULTS: Participants in the Framingham Heart Study were included if they had undergone 2 biennial examinations between 1953 and 1957 and were free of antihypertensive therapy and cardiovascular disease. Compared with optimal BP (SBP <120 and DBP <80 mm Hg), the adjusted hazard ratios (HRs) for developing new-onset IDH over the ensuing 10 years were 2.75 for normal BP, 3.29 for high-normal BP (both P<0.0001), 1.31 (P=0.40) for SDH, and 0.61 (P=0.36) for ISH. The HRs of developing new-onset SDH were 3.32, 7.96, 7.10, and 23.12 for the normal BP, high-normal BP, ISH, and IDH groups, respectively (all P<0.0001). The HRs of developing ISH were 3.26 for normal and 4.82 for high-normal BP (both P<0.0001), 1.39 (P=0.24) for IDH, and 1.69 (P<0.01) for SDH. Increased body mass index (BMI) during follow-up predicted new-onset IDH and SDH. Other predictors of IDH were younger age, male sex, and BMI at baseline. Predictors of ISH included older age, female sex, and increased BMI during follow-up. CONCLUSIONS: Given the propensity for increased baseline BMI and weight gain to predict new-onset IDH and the high probability of IDH to transition to SDH, it is likely that IDH is not a benign condition. ISH arises more commonly from normal and high-normal BP than from "burned-out" diastolic hypertension. |
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