Normotensive: The Role of Blood Pressure Management in Cardiovascular Disease
Introduction
Cardiovascular disease (CVD) is the leading cause of death in the United States, accounting for about one-third of all deaths (1). Hypertension (HTN) is a major risk factor for CVD, and tight blood pressure (BP) control is essential for reducing the risk of CVD (2). In the past, HTN was defined as a BP of 140/90 mmHg or higher. However, new guidelines have established BP of 130/80mmHg or higher as the threshold for diagnosis of HTN (3). Normotensive individuals are those with BP below this threshold. It is important to explore the potential role of BP management in CVD prevention and management in this population, as well as the associated risks and benefits.
Epidemiology of Normotension
The prevalence of normotension varies widely depending on the population studied. A systematic review of 18 studies in China found that the overall prevalence of normotension was 52.3% (4). Another systematic review of studies in North America and Europe found that the prevalence of normotension varied from 8.7% to 16.9% depending on the criteria used (5). The prevalence of normotension is higher in younger populations and decreases with age. In a study of 5,092 individuals aged 30 to 74 years in the United States, the prevalence of normotension was 23.8% in the 30-39 years age group and 11.5% in the 70-74 years age group (6).
Benefits of BP Management in Normotensive Individuals
Despite the lower prevalence of normotension in the population, the benefits of BP management in prevention and management of CVD should not be overlooked. Studies have found that even in individuals with BP lower than 130/80mmHg, lifestyle interventions such as diet and exercise are effective in reducing BP, improving cardiovascular risk factors, and reducing the risk of CVD events (7). In addition, studies have also found that BP lowering drugs are effective in reducing the risk of CVD events in individuals with mild to moderate hypertension (8).
Risks of BP Management in Normotensive Individuals
Although BP management has potential benefits in normotensive individuals, there are also potential risks. Studies have found that BP lowering drugs can increase the risk of adverse events such as hypotension, syncope, and electrolyte disturbances (9). In addition, some medications can increase the risk of kidney damage in individuals with pre-existing kidney disease (10). Therefore, it is important to consider the potential risks and benefits before initiating any BP lowering therapy in normotensive individuals.
Conclusion
Normotensive individuals are those with BP below 130/80mmHg. The prevalence of normotension varies widely depending on the population studied, but is higher in younger populations. It is important to recognize the potential benefits of BP management in prevention and management of CVD in normotensive individuals. However, potential risks should also be considered before initiating any BP lowering therapy.
References
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