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Meta-Analysis
. 2015 Feb 19;4(2):e001519.
doi: 10.1161/JAHA.114.001519.

Prehypertension and the risk of coronary heart disease in Asian and Western populations: a meta-analysis

Yuli Huang  1 , Xiaoyan Cai  2 , Changhua Liu  1 , Dingji Zhu  1 , Jinghai Hua  1 , Yunzhao Hu  2 , Jian Peng  1 , Dingli Xu  1
Affiliations
Meta-Analysis

Prehypertension and the risk of coronary heart disease in Asian and Western populations: a meta-analysis

Yuli Huang et al. J Am Heart Assoc. .

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.

Methods and 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.

Keywords: cardiovascular disease; coronary heart disease; prehypertension; risk.

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Figures

Figure 1.
Figure 1.
Flow of papers through review. BP indicates blood pressure; RRs, relative risks.
Figure 2.
Figure 2.
Forest plot of comparison: prehypertension vs optimal blood pressure. Outcome was coronary heart disease in Asian and Western participants.
Figure 3.
Figure 3.
Funnel plot of comparison, prehypertension vs optimal blood pressure. Outcome was coronary heart disease in Asian and Western participants. RR indicates relative risks.
See this image and copyright information in PMC

Comment in

References

    1. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JJ, Jones DW, Materson BJ, Oparil S, Wright JJ, Roccella EJ. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA. 2003; 289:2560-2572. - PubMed
    1. Huang Y, Cai X, Li Y, Su L, Mai W, Wang S, Hu Y, Wu Y, Xu D. Prehypertension and the risk of stroke: a meta‐analysis. Neurology. 2014; 82:1153-1161. - PubMed
    1. Huang Y, Wang S, Cai X, Mai W, Hu Y, Tang H, Xu D. Prehypertension and incidence of cardiovascular disease: a meta‐analysis. BMC Med. 2013; 11:177. - PMC - PubMed
    1. Qureshi AI, Suri MF, Kirmani JF, Divani AA, Mohammad Y. Is prehypertension a risk factor for cardiovascular diseases? Stroke. 2005; 36:1859-1863. - PubMed
    1. Lee ET, Howard BV, Wang W, Welty TK, Galloway JM, Best LG, Fabsitz RR, Zhang Y, Yeh J, Devereux RB. Prediction of coronary heart disease in a population with high prevalence of diabetes and albuminuria: the Strong Heart Study. Circulation. 2006; 113:2897-2905. - PubMed

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