Many "Pre" Patients May Not be as Healthy as They Think

Three separate studies announced today at the American Society of Hypertension Inc.'s 25th Annual Scientific Meeting and Exposition (ASH 2010) examined the cardiovascular consequences of relatively healthy patients – those who were asymptomatic and not classified as hypertensive or diabetic – and found that many patients who appear healthy may still be at risk for cardiovascular disease. While not meeting the criteria for a diagnosis of hypertension or diabetes, patients in these studies did meet criteria for prediabetes and/or prehypertension. These studies address and measure various cardiovascular risk factors and indicators to identify structural and functional changes that occur early in the hypertension and diabetes disease progression cycle.

“Diabetes and hypertension have reached epidemic status, not only in the U.S., but across the globe,” Henry R. Black, MD, President of ASH. “We are encouraged by research that sheds light on early indicators of cardiovascular disease which may lead to better methods of predicting, and ultimately preventing, these devastating illnesses.”

Apparently Healthy U.S. Adults with Coexisting Prehypertension and Prediabetes Prone for Early Cardiovascular Events (OR-31)
In the first study, researchers examined data on disease-free adults in the NHANES database (1999-2006) and diagnosed pre-hypertensive and pre-diabetic patients using the JNC 7 and ADA criteria (SBP 120-139 and/or DBP 80-89 mm Hg; FBS 100-125 mg/dL).

Researchers found that one in three apparently healthy adults had prehypertension and one in four of otherwise healthy individuals had prediabetes. Collectively, one in ten had both prehypertension and prediabetes. Adults who had both prehypertension and prediabetes were also overweight, had a larger waist circumference (abdominal obesity), higher “whole body” inflammation and insulin (a hormone that reduces blood glucose). These subjects also had higher pulse pressure (the difference between the systolic and diastolic blood pressure), higher total cholesterol, triglycerides, higher “bad cholesterol” along with lower “good cholesterol.” These total, bad and good cholesterol levels made their “risk ratios” above desirable levels. All of these measures individually, and collectively, indicate an early high risk for heart attack or stroke.

“We would like to propose that prehypertension (blood pressure above120/80 mm Hg) and prediabetes (blood sugar of more than 100 mg/dL) occurring together, should be a red flag for urgent further evaluation,” said lead author, Alok K. Gupta, M.D., assistant professor with Clinical Research, Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge. “Resting blood pressure and spot finger stick sugar tests (more than 140 mg/dL 2 hours after a meal which may indicate prediabetes) are obtained for every patient who visits a doctor’s office. This early recognition and subsequent intervention with lifestyle measures may prevent high blood pressure and diabetes from occurring later in life - reducing risk in otherwise healthy adults.”