Clinical InvestigationHypertensionAssociation of all-cause and cardiovascular mortality with prehypertension: A meta-analysis
Section snippets
Search strategy and selection criteria
Electronic databases (PubMed, EMBASE, and the Cochrane Library) were searched to the third week of December 2012 using the following terms: “prehypertension,” “prehypertensive,” “pre-hypertension,” “pre-hypertensive,” “high normal blood pressure,” “optimal blood pressure,” or “borderline hypertension” and “mortality,” “death,” “deaths,” or “fatal.” There were no restrictions for language or publication form. In addition, conference proceedings (American College of Cardiology Meeting, American
Selected studies and characteristics
Of the initial 6,318 records, we determined that 50 articles qualified for full review (Figure 1). Our final primary analysis included data for 1,129,098 participants derived from 20 prospective cohort studies, 6, 7, 8, 9, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31 12 reported all-cause and cardiovascular mortality,6, 7, 8, 9, 17, 22, 23, 24, 25, 26, 27, 30 6 reported only cardiovascular mortality,16, 18, 19, 20, 21, 31 and 2 reported only all-cause mortality.28, 29
Discussion
These results show that after controlling for multiple cardiovascular risk factors, prehypertension is significantly associated with CVD mortality, largely driven by high-range prehypertension. The risk for stroke mortality is higher than CHD mortality. The PARs calculation indicated that 10.5% of CVD, 4.8% of CHD, and 14.6% of stroke death could be prevented if prehypertension was eliminated. However, prehypertension is not associated with all-cause mortality.
A previous meta-analysis also
Disclosures
Authorship: All authors had access to the data and played a role in writing this manuscript.
Competing interest: None declared.
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