Prehypertension and cardiovascular risk factors in adults enrolled in a primary care programme.

Abstract

Background: An increase in cardiovascular (CV) disease has been observed in prehypertensive subjects who frequently carry other cardiovascular risk factors. In Brazil, little is known about prehypertension and its association with cardiovascular risk factors.

Objective: To estimate the association between prehypertension and cardiovascular risk factors in a public primary healthcare programme.

Methods: Associations in this cross-sectional study were estimated on the basis of generalized estimating equations. Results are expressed as odds ratio (OR) or adjusted odds ratio (OR(a)) with 95% confidence interval (CI).

Results: The 357 participants were classified as normotensive (64.4%) or prehypertensive (35.6%). In a univariate analysis, prehypertension was statistically associated with male gender, age, table salt use, diabetes, body mass index (BMI), uric acid, and all lipids except high-density lipoprotein cholesterol. When analysis was performed adjusting for gender, age, and table salt use, the association of each metabolic parameter with prehypertension, remained significant for BMI (OR(a) = 1.097; 95% CI 1.035-1.162), triglycerides (OR(a) = 1.008; 95% CI 1.003-1.013), and uric acid (OR(a) = 1.269; 95% CI 1.023- .576). To check for their independence of obesity, associations of triglycerides and uric acid with prehypertension were reanalysed after adjustment for BMI. The association of triglycerides remained statistically significant. A trend of association was present for uric acid. The prevalence of prehypertension paralleled the increase of the number of risk factors.

Conclusion: Prehypertension in Brazil is associated with well-recognized cardiovascular risk factors even in a continuously monitored population such the one under study. Prehypertension can be a valuable clue to alert health professionals to treat underlying perturbations to prevent overt cardiovascular disease.