Objectives In this study, we evaluated the associated cardiovascular disease (CVD) risk factors and vascular damage of prehypertension/hypertension in a Chinese population from the coastal areas of Fujian province.
Methods A total of 3344 people were selected from the coastal areas of Fujian province. The values of blood lipids, blood glucose, serum creatinine (Scr), urine microalbumin (mALB), brachial-ankle pulse wave velocity (baPWV) and the central retinal arteriolar equivalent (CRAE) were estimated. One-way Analysis of Variance (ANOVA) and logistic regression analysis were applied.
Results (1) The age-standardised prevalence rate of prehypertension and hypertension in the coastal areas of Fujian province were 29.96% and 30.01%, respectively. Logistic regression analysis showed that age, abdominal obesity, hypercholesterolemia, hyperuricemia, alcohol consumption and family history of CVD were associated risk factors of prehypertension/hypertension. 72.96% of hypertensive subjects and 46.59% of prehypertensive subjects were found to be with three or more cardiovascular risk factors. (2) We demonstrate that the abnormality rate of urine albumin-to-creatinine ratio (UACR), baPWV, and CRAE in prehypertensive/hypertensive population were significantly higher than normotensives (all P < 0.05). (3) Logistic regression analysis indicated that prehypertension and hypertension can serve as the independent risk factors of UACR, baPWV, and CRAE (all P < 0.05). The prehypertensive/hypertensive groups have greater relative risk of renal, peripheral, and retinal atherosclerosis compared with the normotensive group (all P < 0.01).
Conclusions Prehypertension is a state between hypertension and normotension. In our study, 72.96% of hypertensive subjects and 46.59% of prehypertensive subjects were found to be with three or more cardiovascular risk factors, which indicates that cardiovascular risk factors aggregation phenomenon exists in the prehypertensive/hypertensive population from the coastal areas of Fujian province. Hence, the health education include quitting alcohol, getting more exercise, and keeping a low-fat/low-purine diet should be received by these population to reduce the occurrence of cardiovascular events.
The occurrence rate of early renal, peripheral and retinal vascular damage in the prehypertensive/hypertensive groups were higher in comparison with the normotensive group, and the damage degree worsened with the increase of blood pressure. Additionally, prehypertension and hypertension can serve as the independent risk factors of UACR, baPWV, and CRAE after confounding factors (age, gender, dyslipidemia, etc) were controlled. As a result, in order to reduce the risk of cardiovascular event, some effective measure such as follow-up and early intervention should be taken for prehypertensive people, while the hypertensive patients may benefit from stable BP control for vascular remodelling alleviation and target organ damage prevention.
The prehypertensive/hypertensive population in the coastal area of Xiapu and Lianjiang county of Fujian province were found to be with multiple cardiovascular risk factors. The prehypertensive/ hypertensive subjects have a significantly higher risk of developing vascular damage than those of normotensive subjects.