Prehypertension and cardiometabolic risk factors (data of the ESSE-RF study)
https://doi.org/10.18705/1607-419X-2017-23-3-243-252
Abstract
The objective of our work was to assess the prevalence of prehypertension (PHT) and the relationship with cardiovascular risk factors in the population sample of the inhabitants of the Russian Federation. Design and methods. The ESSE-RF study was carried out in 12 regions of the Russian Federation (Volgograd, Vologda, Voronezh, Vladivostok, Ivanovo, Kemerovo, Krasnoyarsk, Orenburg, Tomsk, Tyumen, St Petersburg, and North Ossetia (Alania)) with different climatic, geographic, economic and demographic characteristics. A stratified random sample was formed in each region. In total, 20652 inhabitants of the Russian Federation aged 25–65 years were examined. All participants signed informed consent and completed approved questionnaires regarding behavioral risk factors, socioeconomic status and concomitant diseases/therapy. Anthropometry, fasting blood sampling, measurement of blood pressure (BP) were performed. BP was measured by the OMRON device (Japan) twice on the right arm in the sitting position with calculation of the mean BP. The optimal blood pressure corresponds to the BP level < 120/80 mm Hg. The normal BP is 120–129/80–84 mm Hg. High normal BP is 130–139/85–89 mm Hg. PHT is diagnosed in case of BP 120–139/80–89 mm Hg. Hypertension is diagnosed case of BP ≥ 140/90 mm Hg or antihypertensive therapy. PHT includes groups of normal and high normal blood pressure. The statistical analysis was carried out using SPSS Statistics 20. Results. Data of 20607 participants were analyzed, among them 7806 men (37,9 %) and 12801 women (62,1 %). The optimal BP was registered in 3848 (23,4 %), normal BP in 3551 (20,1 %), high normal BP in 2861 (14,9 %), PHT — in 6412 (35,0 %), hypertension — in 10347 (41,6 %). The prevalence is standardized according to the age structure of the World Health Organization (2000). Among men, compared with women, PHT was significantly more frequent (41,2 % and 30,1 %, respectively). The probability of PHT, adjusted for sex, age and obesity is associated with hypercholesterolemia > 4,9 mmol / l (OR 1,27 [1,15, 1,39]), increased HDL > 3,0 mmol / l (1,25 [1,14, 1,37]), triglycerides > 1,7 mmol / l (OR 1,39 [1,23, 1,58]), hyperglycemia ≥ 5,6 mmol / l (OR 1,46 [1,28, 1,67], p < 0,05). The presence of higher education reduced the likelihood of PHT, behavioral risk factors were not significant predictors. Conclusions. The results demonstrate the high prevalence of PHT and the association of metabolic abnormalities with the transformation of optimal blood pressure in PHT, which emphasizes the importance of timely diagnosis of PHT and correction of cardiometabolic risk factors in the Russian population.
About the Authors
A. M. ErinaRussian Federation
MD, Researcher, Scientific Laboratory “Epidemiology of Non-communicable Diseases”, Heart and Vessels Institute
O. P. Rotar
Russian Federation
MD, PhD, DSc, Head, Scientific Laboratory “Epidemiology of Non-communicable Diseases”, Heart and Vessels Institute
2 Akkuratov street, St Petersburg, 197341
Phone: +7(812)702–37–56
A. V. Orlov
Russian Federation
MD, Researcher, Scientific Laboratory “Epidemiology of Non-communicable Diseases”, Heart and Vessels Institute
V. N. Solntsev
Russian Federation
PhD, Senior Researcher, Scientific Laboratory for Mathematical Modeling
S. A. Shalnova
Russian Federation
MD, PhD, DSc, Professor, Head, Department “Epidemiology of Chronic Non-communicable Diseases»
A. D. Deev
Russian Federation
PhD of physical and mathematical sciences, Head, Biostatistics Laboratory
E. I. Baranova
Russian Federation
MD, PhD, DSc, Professor, Department of Internal Diseases 1 with the Course of Endocrinology, Director, Research Institute of Cardiovascular Diseases
Head, Laboratory “Metabolic Syndrome”, Institute of Endocrinology
A. O. Konradi
Russian Federation
MD, PhD, DSc, Professor, Corresponding Member of the Russian Academy of Sciences, Deputy General Director on Research
Director, Institute of Translational Medicine
I. E. Chazova
Russian Federation
MD, PhD, DSc, Professor, Academician of the Russian Academy of Sciences, Deputy General Director on Research, Russian Cardiology Research and Production Complex, Director
S. A. Boytsov
Russian Federation
MD, PhD, DSc, Professor, Corresponding Member of the Russian Academy of Sciences, Acting General Director
E. V. Shlyakhto
Russian Federation
MD, PhD, DSc, Professor, Academician of the Russian Academy of Sciences, General Director
References
1. GBD 2015 Risk Factors Collaborators. Global, regional, and national comparative risk assessment of 79 behavioral, environmental and occupational, and metabolic risks or clusters of risks, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016;388(10053):1659–1724.
2. Forouzanfar MH, Liu P, Roth GA, Ng M, Biryukov S, Marczak L. Global burden of hypertension and systolic blood pressure of at least 110 to 115 mm Hg 1990–2015. JAMA. 2017;317 (2):165–182.
3. Ланг Г.Ф. Гипертоническая болезнь.М.: Медгиз, 1950. 496 с. [Lang GF. Arterial hypertension. Moscow: Medgiz, 1950. 496 p. In Russian].
4. Vasan R, Larson M, Leip E, Kannel W, Levy D. Assessment of frequency of progression to hypertension in nonhypertensive participantsin the Framingham Heart Study: a cohort study. Lancet. 2001;358 (9594):1682–1686.
5. Liszka H, Mainous A, King D, Everett C, Egan B. Prehypertension and cardiovascular morbidity. Ann Fam Med. 2005;3(4): 294–299.
6. Guo X, Zhang X, Zhang L, Guo L, Li Z, Yu S et al. Prehypertension is not associated with all-cause mortality: a systematic review and meta-analysis of prospective studies. PLos One. 2013;8 (4)e61796.
7. Erem C, Hacihasanoglu A, Kocak M, Deger O, Topbas M. Prevalence of prehypertension and hypertension and associated risk factors among Turkish adults: Trabzon Hypertension Study. J Public Health (Oxf). 2009;31(1):47–58.
8. Isezuo S, Sabir A, Ohwovorilole A, Fasanmade O. Prevalence, associated factors and relationship between prehypertension and hypertension: a study of two ethnic African populationsin Northern Nigeria. J Hum Hypertens. 2011;25(4):224–230.
9. Фомин И. В., Бадин Ю. В., Поляков Д. С., Беленков Ю.Н., Мареев В.Ю., Агеев Ф.Т. и др. Предгипертония: как часто встречается данное состояние сердечно-сосудистой системы у граждан Европейской части России (данные исследования ЭПОХА-АГ, 2002–2007). Клиническая медицина. 2013;5(2):38–46. [Fomin IV, Badin YuV, Polyakov DS, Belenkov YuN, Mareyev VYu, Ageev FT et al. Prehypertension: how often does this state of the cardiovascular system occur in citizens of the European part of Russia (data from the EPOCHA-AH study, 2002–2007). Klinicheskaya Meditsina = Clinical Medicine. 2013;5(2):38–46. In Russian].
10. Ерина А.М., Ротарь О.П., Солнцев В.Н., Харченко А.В., Михин В.П., Конради А.О. и др. Предгипертензия и факторы риска сердечно-сосудистых заболеваний у жителей города Курска. Артериальная гипертензия. 2012;18(6):523–530. [Erina AM, Rotar OP, Solntsev VN, Kharchenko AV, Mikhin VP, Konradi AO et al. Prehypertension and risk factors for cardiovascular diseases among residents of the city of Kursk. Arterial’naya Gipertenziya = Arterial Hypertension. 2012;18(6):523–530. In Russian].
11. Научно-организационный комитет проекта ЭССЕ-РФ. Эпидемиология сердечно-сосудистых заболеваний в различных регионах России (ЭССЕ-РФ). Обоснование и дизайн исследования. Профилактическая медицина. 2013;16(6):25–34. [Scientific Organizing Committee of the ESSE-RF. Epidemiology of cardiovascular diseasesin different regions of Russia (ESSE-RF). The rationale for and design of the study. Profilakticheskaya Meditsina = Preventive Medicine. 2013;16(6):25–34. In Russian].
12. Всемирная организация здравоохранения. Проект комплексной глобальной системы мониторинга, включая показатели и комплекс добровольных глобальных целей по профилактике неинфекционных заболеваний и борьбе с ними. Женева. 2012. A_NCD_INF1 ru.pdf. [WHO. A comprehensive global monitoring framework, including indicators, and a set of voluntary global targets for the prevention and control of noncommunicabale diseases. Geneva. 2012. In Russian]
13. Национальные рекомендации по кардиоваскулярной профилактике. Кардиоваскулярная терапия и профилактика. 2011;10(6), приложение 2:1–64. [National guidelines on cardiovascular prevention. Profilakticheskaya Meditsina = Preventive Medicine. 2011;10(6), Suppl. 2:1–64. In Russian].
14. Gupta A, McGlone M, Greenway F, Johnson W. Prehypertension in disease-free adults: a marker for an adverse cardiometabolic risk profile. Hypertens Res. 2010;33(9):905–910.
15. Kim Y, Seunghee Lee S. Prevalence and risk factors associated with prehypertension by gender and age in a Korean Population in the KNHANES 2010–2012. Iran J Public Health. 2015;44(12):1594–1602.
16. Wang R, Lu X, Hu Y, You T. Prevalence of prehypertension and associated risk factors among health check-up population in Guangzhou, China. Int J Clin Exp Med. 2015;8(9):16424–16433.
17. Chockalingam A, Ganesan N, Venkatesan S, Gnanavelu G, Subramaniam T, Jaganathan V et al. Patterns and predictors of prehypertension among “healthy” urban adults in India. Angiology. 2005;56(5):557–563.
18. Guo X, Zou L, Zhang X, Li J, Zheng L, Hu J et al. Prehypertension. A meta-analysis of the epidemiology, risk factors, and predictors of progression. Tex Heart Inst J. 2011;38(6): 643–652.
19. Tabrizi J, Sadeghi-Bazargani H, Farahbakhsh M, Nikniaz L, Nikniaz Z. Prevalence and associated factors of prehypertension and hypertension in Iranian Population: The Lifestyle Promotion Project (LPP). Plos One. 2016;11 (10): e0165264.
20. Xiu-Jun Meng, Guang-Hui Dong, Da Wang et al. Epidemiology of Prehypertension and Associated Risk Factors in Urban Adults From 33 Communitiesin China. The CHPSNE Study. Circ J. 2012; 76(4): 900–906.
21. Riccioni G, De Santis A, Cerasa V, Menna V, Di Ilio C, Schiavone C et al. Atherosclerotic plaque formation and risk factors. Int J Immunopathol Pharmacol. 2003;16(1):25–31.
Review
For citations:
Erina A.M., Rotar O.P., Orlov A.V., Solntsev V.N., Shalnova S.A., Deev A.D., Baranova E.I., Konradi A.O., Chazova I.E., Boytsov S.A., Shlyakhto E.V. Prehypertension and cardiometabolic risk factors (data of the ESSE-RF study). "Arterial’naya Gipertenziya" ("Arterial Hypertension"). 2017;23(3):243-252. https://doi.org/10.18705/1607-419X-2017-23-3-243-252