New results from the Hypertension and Ambulatory Recording Venetia Study (HARVEST) are offering a glimpse at a group typically overlooked in hypertension studies: people who manage to avoid developing the disease over the long term.
Dr Paolo Palatini (University of Padova, Italy) presented the findings here at the 2013 International Conference on Prehypertension and Cardiometabolic Syndrome.
The analysis, he said, may have implications for hypertension guidelines that typically recommend a delay to treatment in the range of several months for patients diagnosed with grade 1 hypertension. The data Palatini presented today detail the characteristics of young adults (mean age 33) diagnosed with grade 1 hypertension whose blood pressure fell to within normal range within the first few months of the study and who then managed to remain normotensive over 15 years of follow-up.
HARVEST was originally designed to examine characteristics of subjects diagnosed with grade 1 hypertension (140-159/90-99 mm Hg) who went on to develop established white-coat, masked, or sustained hypertension over a six-year period.
In the data he presented today, Palatini zeroed in on the 198 subjects whose BP fell to normal (<140/90) in the initial months of HARVEST, as compared with 822 patients who developed hypertension. In this subset, he noted, both systolic and diastolic BP fell sharply between study outset and three months (from grade 1 hypertension to normotensive) and continued to decline over the next decade and a half.
Statistically significant baseline differences included a slightly lower body-mass index (BMI), lower coffee consumption, lower triglycerides, and higher physical-activity levels among patients who remained normotensive. "Overall, they had better metabolic profiles," Palatini said.