From Our 2012 Archives
High-Normal Blood Pressure Raises Heart Risks in Men
Earlier Study Showed Same Thing in Women
By Salynn Boyles
Reviewed by Laura J. Martin, MD
Jan. 17, 2012 -- Having high blood pressure in middle age is a major risk factor for developing atrial fibrillation later in life, and now new research links high-normal-range blood pressure with an increase in risk.
More than 2 million mostly older Americans have the heart rhythm disorder known as atrial fibrillation, which greatly increases their risk for stroke, heart failure, and death.
Researchers followed about 2,000 Norwegian men for an average of 30 years, during which time 270 developed atrial fibrillation.
Men whose systolic blood pressure (the upper number) was in the high-normal range at the start of the study were 50% more likely than men with normal blood pressure to develop the heart rhythm condition.
An earlier study in women who were followed for an average of 14 years also showed high-normal blood pressure to be associated with a higher risk for atrial fibrillation.
Prehypertension and Atrial Fibrillation
In the United States, high blood pressure is defined as a systolic reading of 140 or higher and a diastolic reading of 90 or more.
High-normal blood pressure, also known as prehypertension, is generally defined as having a systolic reading of between 120 and 139 and/or a diastolic reading of 80 to 89.
Atrial fibrillation is characterized by an irregular -- and sometimes rapid -- heartbeat resulting when the two upper chambers and two lower chambers of the heart are not contracting in sync.
Symptoms can include heart palpitations, shortness of breath, general weakness, or no symptoms at all.
In an effort to determine if the earlier findings in women also applied to men, researcher Irene Grundvold, MD, and colleagues from Norway's Oslo University Hospital analyzed data from a study of men who were in their 40s and 50s when first examined in the early- to mid-1970s.
The men were followed for up to 35 years.
The study revealed that:
High-Normal BP Is Patient Wake-Up Call, Says Doctor
On average, the men who developed atrial fibrillation did so around two decades after entering the study.
The findings appear in the February issue of the American Heart Association (AHA) journal Hypertension.
"This study is another example of a metabolic syndrome trait being associated with higher [heart disease and stroke] risk," says AHA spokesman Roger Blumenthal, MD, who directs the Johns Hopkins Ciccarone Preventive Cardiology Center.
Blumenthal says the findings should serve as a wake-up call for those with blood pressure readings in the high-normal range, adding that people with systolic blood pressure readings in the 130s and diastolic readings in the 80s should be counseled to make lifestyle changes that can improve the numbers.
"That means revving up your diet and exercise schedule and losing weight if you are overweight," he says.
SOURCES: Grundvold, I. Hypertension, February, 2012.Conen, D. Circulation, 2009.Irene Grundvold, MD, department of cardiology, Oslo University Hospital, Rikshospitalet, Oslo.Roger Blumenthal, MD, director, Ciccarone Preventive Cardiology Center; professor of medicine/cardiology, Johns Hopkins University School of Medicine, Baltimore; spokesman, American Heart Association.