Background

Although the high disease burden that results from cardiovascular complications of hypertension, factors related to the progression to hypertension in the normotensive population are not actively reported. The purpose of this study was to estimate the rate of the progression to hypertension and to reveal the associated risk factors.

Methods

The study included normotensive participants from the National Health Insurance Service-National Health Screening Cohort, and contained a 10% sample of all adults who received a national health screening test in either 2002 or 2003. At the end of the study in 2015, the patients were divided into two groups based on whether or not they progressed to hypertension. Cox proportional hazard modeling was performed to identify risk factors for progression. Subgroup analysis using logistic regression was employed to reveal factors influencing the different natural history of the progression.

Results

Among the 75,335 included participants, the progression rate to hypertension was 66.39% (50,013), with an adjusted incidence rate of 8.62 per 100 person-year in the aged 40–64 group and 12.68 in the aged 65 or above group. Age, BMI, hemoglobin, and family history of hypertension and other diseases were related to the progression. Among the progression group, 78.21% (39,116) participants skipped a pre-hypertensive status; this group consisted of older females with lower pulse pressure and more alcohol consumption compared to people who had pre-hypertensive status before the progression.

Conclusion

Substantial risk factors for the progression to hypertension should be carefully managed even in normotensive participants who receive health screening tests.

中文翻译：

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高血压进展的危险因素和进展过程中自然史的特征：一项全国队列研究。

背景

尽管高血压的心血管并发症导致了很高的疾病负担，但尚未积极报道与血压正常人群的高血压发展有关的因素。这项研究的目的是评估高血压的进展速度并揭示相关的危险因素。

方法

这项研究包括来自美国国家健康保险局（National Health Insurance Service）-国家健康筛查队列（National Health Screening Cohort）的血压正常参与者，并包含了在2002年或2003年接受国家健康筛查测试的所有成年人的10％的样本。在2015年研究结束时，患者根据是否进展为高血压分为两组。进行了Cox比例风险建模，以识别进展的风险因素。使用逻辑回归进行亚组分析以揭示影响进展的不同自然史的因素。

结果

在75335名参与者中，高血压的进展率为66.39％（50013），40-64岁年龄组的调整发病率为每100人年8.62，而65岁以上年龄组的调整发生率为12.68。年龄，BMI，血红蛋白以及高血压和其他疾病的家族史与病情发展有关。在进展组中，有78.21％（39,116）的参与者跳过了高血压前的状态；该组由年龄较大的女性组成，这些女性的脉搏压较低，饮酒量高于在进展前处于高血压前状态的女性。

结论

即使在接受健康检查的血压正常的参与者中，也应谨慎管理高血压发展的重大危险因素。