Prehypertension and the risk of coronary heart disease in Asian and Western populations: a meta-analysis

Background: the results of studies on the association between prehypertension (blood pressure 120 to 139/80 to 89 mm hg) and coronary heart disease (chd) remain controversial. furthermore,it is unclear whether prehypertension affects the risk of chd in asian and western populations differently. this meta-analysis evaluated the risk of chd associated with prehypertension and its different subgroups.methods and results: the pubmed and embase databases were searched for prospective cohort studies with data on prehypertension and the risk of chd. studies were included if they reported multivariate-adjusted relative risks (rrs) with 95% cis of chd from prehypertension. a total of 591 664 participants from 17 prospective cohort studies were included. prehypertension increased the risk of chd (rr 1.43,95% ci 1.26 to 1.63,p<0.001) compared with optimal blood pressure (<120/80 mm hg). the risk of chd was higher in western than in asian participants (western: rr 1.70,95% ci 1.49 to 1.94; asian: rr 1.25,95% ci 1.12 to 1.38; ratio of rrs 1.36,95% ci 1.15 to 1.61). the population-attributable risk indicated that 8.4% of chd in asian participants was attributed to prehypertension,whereas this proportion was 24.1% in western participants.conclusions: prehypertension,even at the low range,is associated with an increased risk of chd. this risk is more pronounced in western than in asian populations. these results supported the heterogeneity of target-organ damage caused by prehypertension and hypertension among different ethnicities and underscore the importance of prevention of chd in western patients with prehypertension. © 2015 the authors. published on behalf of the american heart association,inc.,by wiley blackwell.