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Pre-hypertension and subclinical carotid damage: a meta-analysis

Journal of Human Hypertension volume 33, pages 34–40 (2019)Cite this article

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Abstract

The association between pre-hypertension (pre-HTN) and subclinical carotid damage is poorly defined. We performed a meta-analysis of ultrasonographic studies assessing carotid intima-media thickness (IMT) in untreated pre-HTN subjects. The OVID-MEDLINE, PubMed, and Cochrane CENTRAL databases were searched for English-language articles without time restriction up to February 2018 through focused, high sensitive search strategies. Studies were identified by crossing the following search terms: “pre-hypertension”, “high normal blood pressure”, “carotid intima-media thickness”, “carotid atherosclerosis”, “ultrasonography”. Overall, 7645 subjects (3374 normotensive, 1936 untreated pre-HTN, and 2335 HTN individuals) of both genders were included in seven studies. In the pooled study population, common carotid IMT showed a progressive increase from normotensive (723 ± 39 µm) to pre-HTN (779 ± 45 µm) (standardized mean difference, SMD 0.36 ± 0.08, CI 0.34–0.46, p < 0.0001) and to HTN subjects (858 ± 82 µm) (SMD 0.39 ± 0.07, CI 0.26–0.54, p = 0.002 vs. pre-HT). The statistical difference did not change after correction for publication bias and was not affected by a single study effect. Our meta-analysis shows that carotid IMT in pre-HTN subjects is intermediate between normotensive and HTN individuals. These findings support the view that pre-HTN is an unfavourable condition that should be properly managed in order to prevent vascular damage.

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Authors and Affiliations

  1. Department of Medicine and Surgery, University of Milano-Bicocca, Milano, Italy

    Cesare Cuspidi, Guido Grassi & Giuseppe Mancia

  2. Istituto Auxologico Italiano, Milano, Italy

    Cesare Cuspidi

  3. Department of Clinical Sciences and Community Health, University of Milano and Fondazione Ospedale Maggiore IRCCS Policlinico di Milano, Milano, Italy

    Carla Sala & Elisa Gherbesi

  4. Department of Cardiology, Charité-University-Medicine Campus Virchow Klinikum, Berlin, Germany

    Marijana Tadic

  5. IRCCS Multimedica, Sesto San Giovanni, Italy

    Guido Grassi

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  1. Cesare Cuspidi
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Correspondence to Cesare Cuspidi.

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Cuspidi, C., Sala, C., Tadic, M. et al. Pre-hypertension and subclinical carotid damage: a meta-analysis. J Hum Hypertens 33, 34–40 (2019). https://doi.org/10.1038/s41371-018-0114-6

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