- Systolic BP (SBP) increases even within normal range are linked to increased risk for atherosclerotic cardiovascular disease (ASCVD).
- The stepwise risk increase begins with SBP as low as 100 mmHg.
Why this matters
- The authors call for “primordial prevention” of ASCVD by limiting BP increases within normal range, as opposed to delaying to primary prevention once hypertension develops.
- Editorial endorses the inference from these findings that SBP increases well within normal range can contribute to ASCVD risk.
- Overall median (interquartile range) 10-year ASCVD risk was 3.0% (95% CI, 1.1%-6.7%).
- With SBP
- With every 10-mmHg SBP increase, the aHR for ASCVD was 1.53 (95% CI, 1.17-1.99).
- Using SBP 90-99 mmHg as reference, ASCVD risk (aHRs; 95% CIs) by normal SBP ranges:
- 100-109 mmHg: 3.00 (1.01-8.88).
- 110-119 mmHg: 3.10 (1.03-9.28).
- 120-129 mmHg: 4.58 (1.47-14.27).
- Cohort study with 1457 participants without ASCVD in the US Multi-Ethnic Study of Atherosclerosis.
- Participants had normal cholesterol, were nonsmokers, and were not taking antihypertensives at entry.
- Funding: National Heart, Lung, and Blood Institute; others.
- Did not account for behavioral risk factors.