Prehypertension and cardiometabolic risk factors (data of the ESSE-RF study)

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.