Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Article
  • Published:

Prevalence of hypertension mediated organ damage in subjects with high-normal blood pressure without known hypertension as well as cardiovascular and kidney disease

Journal of Human Hypertension volume 36, pages 610–616 (2022)Cite this article

Subjects

Abstract

Purpose of our study was to assess the prevalence of hypertension mediated organ damage (HMOD) in healthy subjects with high-normal Blood Pressure (BP) comparing them with subjects with BP values that are considered normal (<130/85 mmHg) or indicative of hypertension (≥140/90 mmHg). Seven hundred fifty-five otherwise healthy subjects were included. HMOD was evaluated as pulse wave velocity (PWV), left ventricular mass index (LVMI), and carotid intima-media thickness (IMT) and plaque. When subjects were classified according to BP levels we found that the high-normal BP group showed intermediate values of PWV and higher values of IMT. This corresponds to intermediate prevalence of arterial stiffness, while there were no differences for increased IMT or carotid plaque. No subjects showed left ventricular hypertrophy. At multivariable analysis, the odds of having arterial stiffness or carotid HMOD in the high-normal group resulted not different to the normal group. In conclusion, in our otherwise healthy population, high-normal BP values were not related to aortic, carotid or cardiac HMOD.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on SpringerLink
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Fig. 1: Hypertension Mediated Organ Damage in the different Blood Pressure group.
Fig. 2: Odds Ratio from unadjusted and adjusted logistic regression models of the Hypertension Mediated Organ Damage variables.

Similar content being viewed by others

References

  1. Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M, et al. ESC/ESH guidelines for the management of arterial hypertension: the task force for the management of arterial hypertension of the European Society of Cardiology (ESC) and the European Society of Hypertension (ESH). Eur Heart J. 2018;39:3021–104.

    Article  Google Scholar 

  2. Mancia G, De Backer G, Dominiczak A, Cifkova R, Fagard R, Germano G, et al. Guidelines for the management of arterial hypertension: the task force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens. 2007;25:1105–87.

    Article  CAS  Google Scholar 

  3. Mancia G, Fagard R, Narkiewicz K, Redon J, Zanchetti A, Bohm M, et al. ESH/ESC guidelines for the management of arterial hypertension: the task force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J. 2013;34:2159–219.

    Article  Google Scholar 

  4. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JJ, et al. National Heart, Lung, and Blood Institute Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure; National High Blood Pressure Education Program Coordinating Committee. The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure: the JNC 7 report. JAMA. 2003;289:2560–72.

    Article  CAS  Google Scholar 

  5. Whelton PK, Carey RM, Aronow WS, Casey DE Jr, Collins KJ, Dennison Himmelfarb C, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2018;138:e426–83.

    PubMed  Google Scholar 

  6. Kokubo Y, Kamide K. High-normal blood pressure and the risk of cardiovascular disease. Circ J. 2009;73:1381–5.

    Article  Google Scholar 

  7. Huang Y, Wang S, Cai X, Mai W, Hu Y, Tang H, et al. Prehypertension and incidence of cardiovascular disease: a meta-analysis. BMC Med. 2013;11:177.

    Article  Google Scholar 

  8. Thomopoulos C, Parati G, Zanchetti A. Effects of blood-pressure-lowering treatment on outcome incidence. 12. Effects in individuals with high-normal and normal blood pressure: overview and meta-analyses of randomized trials. J Hypertens. 2017;35:2150–60.

    Article  CAS  Google Scholar 

  9. Materson BJ, Garcia-Estrada M, Degraff SB, Preston RA. Prehypertension is real and can be associated with target organ damage. J Am Soc Hypertens. 2017;11:704–8.

    Article  Google Scholar 

  10. Delles C. Risk factors and target organ damage: is there a special case for prehypertension? J Hypertens. 2008;26:2268–70.

    Article  CAS  Google Scholar 

  11. Booysen HL, Norton GR, Maseko MJ, Libhaber CD, Majane OH, Sareli P, et al. Aortic, but not brachial blood pressure category enhances the ability to identify target organ changes in normotensives. J Hypertens. 2013;31:1124–30.

    Article  CAS  Google Scholar 

  12. Norton GR, Maseko M, Libhaber E, Libhaber CD, Majane OH, Dessein P, et al. Is prehypertension an independent predictor of target organ changes in young-to-middle-aged persons of African descent? J Hypertens 2008;26:2279–87.

    Article  CAS  Google Scholar 

  13. Cuspidi C, Sala C, Tadic M, Gherbesi E, Facchetti R, Grassi G, et al. High-normal blood pressure and abnormal left ventricular geometric patterns: a meta-analysis. J Hypertens. 2019;37:1312–9.

    Article  CAS  Google Scholar 

  14. Cuspidi C, Sala C, Tadic M, Gherbesi E, Grassi G, Mancia G. Pre-hypertension and subclinical cardiac damage: A meta-analysis of echocardiographic studies. Int J Cardiol. 2018;270:302–8.

    Article  Google Scholar 

  15. Urbina EM, Khoury PR, McCoy C, Daniels SR, Kimball TR, Dolan LM. Cardiac and vascular consequences of pre-hypertension in youth. J Clin Hypertens. 2011;13:332–42.

    Article  Google Scholar 

  16. Cuspidi C, Sala C, Tadic M, Gherbesi E, Grassi G, Mancia G. Pre-hypertension and subclinical carotid damage: a meta-analysis. J Hum Hypertens. 2019;33:34–40.

    Article  Google Scholar 

  17. Lewandowski J, Artyszuk Ł, Ostrowski F, Ciszewski J, Puchalska L, Abramczyk P. Individuals with high-normal blood pressure have different metabolic and haemodynamic characteristics to those with optimal blood pressure. Kardiol Pol. 2012;70:252–8.

    PubMed  Google Scholar 

  18. Toikka JO, Laine H, Ahotup M, Haapanen A, Viikari JS, Hartiala JJ, et al. Increased arterial intima‐media thickness and in vivo LDL oxidation in young men with borderline hypertension. Hypertension. 2000;36:929–33.

    Article  CAS  Google Scholar 

  19. Grassi G, Buzzi S, Dell’Oro R, Mineo C, Dimitriadis K, Seravalle G, et al. Structural alterations of the retinal microcirculation in the “prehypertensive” high-normal blood pressure state. Curr Pharm Des. 2013;19:2375–81.

    Article  CAS  Google Scholar 

  20. Knight EL, Kramer HM, Curhan GC. High-normal blood pressure and microalbuminuria. Am J Kidney Dis. 2003;41:588–95.

    Article  Google Scholar 

  21. Washio M, Tokunaga S, Yoshimasu K, Kodama H, Liu Y, Sasazuki S, et al. Role of prehypertension in the development of coronary atherosclerosis in Japan. J Epidemiol. 2004;14:57–62.

    Article  Google Scholar 

  22. Lehmann N, Erbel R, Mahabadi AA, Kälsch H, Möhlenkamp S, Moebus S, et al. Accelerated progression of coronary artery calcification in hypertension but also prehypertension. J Hypertens. 2016;34:2233–42.

    Article  CAS  Google Scholar 

  23. Maloberti A, Farina F, Carbonaro M, Piccinelli E, Bassi I, Pansera F, et al. In healthy normotensive subjects age and blood pressure better predict subclinical vascular and cardiac organ damage than atherosclerosis biomarkers. Blood Press. 2018;27:262–70.

    Article  Google Scholar 

  24. Levey AS, Coresh J, Greene T, Marsh J, Stevens LA, Kusek JW, et al. Modification of Diet in Renal Disease - Expressing the Modification of Diet in Renal Disease Study equation for estimating glomerular filtration rate with standardized serum creatinine values. Clin Chem. 2007;53:766–72.

    Article  CAS  Google Scholar 

  25. The Reference Values for Arterial Stiffness’ Collaboration. Determinants of pulse wave velocity in healthy people and in the presence of cardiovascular risk factors: ‘establishing normal and reference values’. Eur Heart J. 2010;31:2338–50.

    Article  Google Scholar 

  26. Bruno RM, Cartoni G, Stea F, Armenia S, Bianchini E, Buralli S, et al. Carotid and aortic stiffness in essential hypertension and their relation with target organ damage: the CATOD study. J Hypertens. 2017;35:310–8.

    Article  CAS  Google Scholar 

  27. Devereux RB, Reichek N. Echocardiographic determination of left ventricular mass in man. Anatomic validation of the method. Circulation. 1977;55:613–8.

    Article  CAS  Google Scholar 

  28. Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging. 2015;16:233–70.

    Article  Google Scholar 

  29. Liao Y, Cooper RS, Durazo-Arvizu R, Mensah GA, Ghali JK. Prediction of mortality risk by different methods of indexation for left ventricular mass. J Am Coll Cardiol. 1997;29:641–7.

    Article  CAS  Google Scholar 

  30. Maloberti A, Meani P, Varrenti M, Giupponi L, Stucchi M, Vallerio P, et al. Structural and Functional Abnormalities of Carotid Artery and Their Relation with EVA Phenomenon. High Blood Press Cardiovasc Prev. 2015;22:373–9.

    Article  Google Scholar 

  31. Engelen L, Ferreira I, Stehouwer CD, Boutouyrie P, Laurent S. Reference Values for Arterial Measurements Collaboration. Reference intervals for common carotid intima-media thickness measured with echotracking: relation with risk factors. Eur Heart J. 2013;34:2368–80.

    Article  CAS  Google Scholar 

  32. Touboul P-J, Hennerici M, Meairs S, Adams H, Amarenco P, Desvarieux M, et al. Mannheim intima-media thickness consensus. Cerebrovasc Dis. 2004;18:346–9.

    Article  Google Scholar 

  33. Bajpai JK, Sahay AP, Agarwal AK, De AK, Garg B, Goel A. Impact of prehypertension on left ventricular structure, function and geometry. J Clin Diagn Res. 2014;8:BC07–10.

    PubMed  PubMed Central  Google Scholar 

  34. Li T, Yang J, Guo X, Chen S, Sun Y. Geometrical and functional changes of left heart in adults with prehypertension and hypertension: a cross-sectional study from China. BMC Cardiovasc Disord. 2016;16:114.

    Article  Google Scholar 

  35. Cuspidi C, Facchetti R, Bombelli M, Tadic M, Sala C, Grassi G, et al. High normal blood pressure and left ventricular hypertrophy echocardiographic findings from the PAMELA population. Hypertension. 2019;73:612–9.

    Article  CAS  Google Scholar 

  36. Meani P, Maloberti A, Sormani P, Colombo G, Giupponi L, Stucchi M, et al. Determinants of carotid-femoral pulse wave velocity progression in hypertensive patients over a 3.7 years follow-up. Blood Press. 2018;27:32–40.

    Article  Google Scholar 

  37. Cuspidi C, Negri F, Muiesan ML, Capra A, Lonati L, Milan A, et al. Working Group on Heart and Hypertension, Italian Society of Hypertension. Prevalence and severity of echocardiographic left ventricular hypertrophy in hypertensive patients in clinical practice. Blood Press. 2011;20:3–9.

    Article  Google Scholar 

  38. Huang LC, Lin RT, Chen CF, Chen CH, Juo SH, Lin HF. Predictors of Carotid Intima-Media Thickness and Plaque Progression in a Chinese Population. J Atheroscler Thromb. 2016;23:940–9.

    Article  CAS  Google Scholar 

  39. Muiesan ML, Pasini G, Salvetti M, Calebich S, Zulli R, Castellano M, et al. Cardiac and vascular structural changes. Prevalence and relation to ambulatory blood pressure in a middle-aged general population in northern Italy: the Vobarno Study. Hypertension. 1996;27:1046–52.

    Article  CAS  Google Scholar 

Download references

Author contributions

AM: Substantial contributions to the conception and design of the work, contributions in the data acquisition and its interpretation. Substantial contributions in drafting the work; final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. PR: Substantial contributions to the data analysis and its interpretation. Substantial contributions in drafting the work; final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. GO: Substantial contributions to the data analysis and its interpretation. Substantial contributions in the critical revision of the work; Final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. MA: Substantial contributions to data interpretation. Substantial contributions to the critical revision of the work; final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. FM: Substantial contributions to data interpretation. Substantial contributions to the critical revision of the work; final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. OB: Substantial contributions to data interpretation. Substantial contributions to the critical revision of the work; final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. FS: Substantial contributions to data interpretation. Substantial contributions to the critical revision of the work; final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. GMS: Substantial contributions to data interpretation. Substantial contributions to the critical revision of the work; final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. LO: Substantial contributions to data interpretation. Substantial contributions the critical revision of the work; final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. BDC: Substantial contributions to data interpretation. Substantial contributions to the critical revision of the work; final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. FC: Substantial contributions to data interpretation. Substantial contributions to the critical revision of the work; final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. AM: Substantial contributions to data interpretation. Substantial contributions to the critical revision of the work; final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. MGV: Substantial contributions to data acquisition and interpretation. Substantial contributions the critical revision of the work; final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. CG: Substantial contributions to data acquisition and interpretation. Substantial contributions the critical revision of the work; final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Funding

This work was funded by the European Community Seventh Framework Programme (FP7/2007-2013) Grant Agreement no 278249, Italian Ministry of University and Research (MIUR) - Department of Excellence project PREMIA (PREcision MedIcine Approach: bringing biomarker research to clinic), A. De Gasperis Cardiology and Cariac Surgery Foundation.

Author information

Authors and Affiliations

  1. Cardiology IV, “A.De Gasperis” Department, ASTT GOM Niguarda Ca’ Granda, Milan, Italy

    Alessandro Maloberti, Marta Alloni, Francesco Musca, Oriana Belli, Francesca Spano, Gloria Maria Santambrogio, Lucia Occhi, Benedetta De Chiara, Francesca Casadei, Antonella Moreo & Cristina Giannattasio

  2. University of Milano-Bicocca, Milan, Italy

    Alessandro Maloberti & Cristina Giannattasio

  3. Bicocca Center of Bioinformatics, Biostatistics and Bioimaging (B4 center), School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy

    Paola Rebora, Giuseppe Occhino & Maria Grazia Valsecchi

Authors
  1. Alessandro Maloberti
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Paola Rebora
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Giuseppe Occhino
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Marta Alloni
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Francesco Musca
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Oriana Belli
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Francesca Spano
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Gloria Maria Santambrogio
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Lucia Occhi
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Benedetta De Chiara
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Francesca Casadei
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Antonella Moreo
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Maria Grazia Valsecchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Cristina Giannattasio
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Alessandro Maloberti.

Ethics declarations

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Maloberti, A., Rebora, P., Occhino, G. et al. Prevalence of hypertension mediated organ damage in subjects with high-normal blood pressure without known hypertension as well as cardiovascular and kidney disease. J Hum Hypertens 36, 610–616 (2022). https://doi.org/10.1038/s41371-021-00604-6

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41371-021-00604-6

This article is cited by

Search

Advanced search

Quick links