Abstract | BACKGROUND: METHODS: We analyzed data on 3449 adults (mean age 41.0 years), prehypertensive at baseline, attending at least one follow-up visit, contributing 25,079 person-years follow-up. A proportional hazard regression analysis was implemented to model the interval-censored progression-free survival time data using readily-assessable, commonly-available information. Integrated discriminatory improvement (IDI) and net reclassification improvement (NRI) indices were calculated to examine whether simple clinical information could help improve prediction of prehypertension-to- hypertension progression rate based on the blood pressure measures. RESULTS: During a median seven-year follow-up 1412 prehypertensive patients progressed to hypertension with annual progression rate (95% confidence intervals (CIs)) being 56.9 (52.9-61.2) per 1000 women and 55.7 (51.7-60.0) per 1000 men (p = 0.007). High-density lipoprotein cholesterol levels were inversely associated with prehypertension-to- hypertension progression rate only among women (hazard ratio (1-SD): 0.93, 95% CIs: 0.86-0.100). Marital status retained its predictability among women even after multivariate adjustments. In both men and women, age, blood pressure measures, waist-to-height ratio, fasting plasma glucose and a history of cardiovascular disease independently predicted prehypertension-to- hypertension rate. The absolute (0.114, 95% CIs: 0.107-0.120) and relative (2.638, 95% CIs: 2.374-2.903) IDI and cutpoint-based (0.213, 95% CIs: 0.156-0.269) and cutpoint-free NRI (0.523, 95% CIs: 0.455-0.591) indicated that the prediction of the prehypertension-to- hypertension progression was improved by multivariable-models compared with blood pressure measures alone. DISCUSSION: Easily-assessable, commonly-available information helped improve predictability of blood pressure measures for prehypertension-to- hypertension progression. Women's psycho-social characteristics (marital status) should be considered in prevention of prehypertension-to- hypertension progression.
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Authors | Mohammadreza Bozorgmanesh, Hadi Ghoreishian, Reza Mohebi, Fereidoun Azizi, Farzad Hadaegh |
Journal | European journal of preventive cardiology
(Eur J Prev Cardiol)
Vol. 21
Issue 8
Pg. 956-63
(Aug 2014)
ISSN: 2047-4881 [Electronic] England |
PMID | 23478742
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Copyright | © The European Society of Cardiology 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav. |
Topics |
- Adult
- Cross-Sectional Studies
- Demography
- Disease Progression
- Female
- Humans
- Hypertension
(epidemiology, physiopathology)
- Iran
(epidemiology)
- Male
- Prehypertension
(epidemiology, physiopathology)
- Prevalence
- Prospective Studies
- Risk Factors
- Sex Factors
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