Systolic BP Threshold Predicts Progression to Hypertension

A resting systolic blood pressure (BP) that tends to exceed 120 to 125 mm Hg predicts subsequent onset of hypertension, according to a recent study.

For their study, the researchers evaluated 1252 participants who were enrolled in the Framingham Original Cohort. The researchers collected up to 28 serial examinations of standardized resting BP measurements recorded between 1948 and 2005 from each participant.
___________________________________________________________________________

RELATED CONTENT
Guidelines for BP Response During Exercise Need to Be Updated
BP Tends to Decrease in the 10 Years Before Death
___________________________________________________________________________

Significant change points in the association between advancing age and increasing systolic BP were examined using a segmented mixed model.

Findings indicated that resting systolic BP levels prior to hypertension onset were relatively stable among participants in this cohort.

However, the researchers observed a more rapid increase in systolic BP levels after reaching a level of 123.2 mm Hg among individuals aged 40 to 49 years at onset, 122.0 mm Hg among those aged 50 to 59 years at onset, 124.9 mm Hg among those aged 60 to 69 years at onset, and 120.5 mm Hg among those between 70 and 79 years at onset.

“We observed that individuals in the community generally maintained a systolic BP of less than 120 to 125 mm Hg, above which systolic BP increased at a relatively rapid rate toward overt hypertension,” the researchers concluded. “This trend was consistent whether the hypertension manifested earlier or later in life.”

“Thus, a resting systolic BP that chronically exceeds the range of approximately 120 to 125 mm Hg may represent an important threshold of underlying vascular remodeling and signal incipient hypertension irrespective of age,” they continued. “Further investigations are needed to unravel the sequence of hemodynamic and vascular changes occurring prior to hypertension onset.”

—Christina Vogt

Reference:

Niiranen TJ, Henglin M, Claggett B, et al. Trajectories of blood pressure elevation preceding hypertension onset: an analysis of the Framingham Heart Study original cohort [Published online March 21, 2018]. JAMA Cardiol. doi:10.1001/jamacardio.2018.0250.