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Prehypertension is highly prevalent and associated with the risk of progression to overt hypertension. Nevertheless, less attention has been paid to this patient category. This study aimed to evaluate the association between prehypertension with preclinical end-organ damage and the exercise capacity.
From January 2011 to May 2013, we retrospectively identified 447 asymptomatic participants with a blood pressure (BP) of <140/90mmHg who underwent comprehensive health check-ups at tertiary hospitals. Those on antihypertensive medications (n=65) were excluded. A total of 382 patients (mean age 53±9 years, females 36.9%) were entered into the final analysis and categorized into two groups: optimal BP (systolic BP < 120mmHg and diastolic BP < 80mmHg, n=173) and prehypertension (120 ≤ systolic BP < 140mmHg and/or 80 ≤ diastolic BP < 89mmHg, n=209).
Participants with prehypertension exhibited more obese features (body mass index, 25.1±3.7 vs. 24.3±3.6kg/m2; p<0.001). The laboratory findings demonstrated higher levels of the fasting glucose (103.8±26.0 vs. 97.2±21.6mg/dL, p=0.007), HOMA-IR (1.18±0.87 vs. 0.87±0.55, p<0.001), uric acid (6.0±1.4 vs. 5.4±1.3mg/dL, p<0.001), and triglycerides (123.1±87.9 vs. 101.3±59.7mg/dL, p=0.005) in prehypertension subjects. They also had a higher LV mass index (84.5±16.7 vs. 76.2±14.4g/m2, p<0.001) and E/e', and lower LV ejection fraction, but the latter two were not statistically significant. However, no significant difference in the exercise capacity was noted between the two groups (peak VO2; 28.3±7.7 vs. 27.9±6.9mL/kg/min, p=0.616). A multivariate linear regression analysis demonstrated that the age (β=-0.142, p<0.001), muscle mass (β=0.429, p<0.001), and fat mass (β=-0.361, p<0.001), but not the value of the blood pressure, were independent determinants of the exercise capacity in these subjects.
Our observations demonstrated that prehypertension was associated with a metabolic disorder and preclinical end-organ damage, but not with the exercise capacity.