Variation in body composition determines long-term blood pressure changes in pre-hypertension: the MONICA/KORA (Monitoring Trends and Determinants on Cardiovascular Diseases/Cooperative Research in the Region of Augsburg) cohort study.

Description

This prospective study was performed to examine the impact of variations in body composition on blood pressure over a 10-year period. A group of 365 subjects with pre-hypertension at baseline were followed up and then divided in 3 subgroups, 48 had normalized blood pressure (PreNorm), 134 still had pre-hypertension (PrePre) and 183 showed progression to hypertension (PreHyp). In parallel, another study to determine predictors of changes in blood pressure category was performed in individuals hypertensive at baseline (n=429). The prevalence of pre-hypertension in this population-based sample was 31.9% at baseline and the rate of progression from pre-hypertension to hypertension was 50% over a 10-year period. Beyond age, the most important contributors to the evolution from pre-hypertension to hypertension were dynamic weight changes which resulted mainly from an increase in body fat mass. Individuals who maintained their pre-hypertension status presented with a significantly less pronounced increase in body weight and fat mass. As for the pre-hypertensive group at baseline who normalized their blood pressure, no significant changes in body weight and fat mass were found. Hypertensive individuals at baseline whose blood pressure levels decreased were characterized by a marked decrease in fat mass (kg and %). Thus, these results suggest that weight maintenance in pre-hypertensive subjects is an effective mean to prevent the development of hypertension.