Prediction of future hypertension by casual blood pressure or invasive hemodynamics? A 30-year follow-up study.

Blood pressure elevation in young age is associated with a risk of developing hypertension. However, not all subjects will progress to clinical hypertensives in need of pharmacological therapy. In younger subjects, there is essential to find clinical or experimental characteristics to predict the future risk of hypertension. In the present study, the long-term relationship between casual blood pressure measurement and future hypertension has been examined. The initial study group consisted of 20-year-old men (n = 44) with mild blood pressure elevation and a normotensive male control group (n = 29). After 30 years, we re-examined 32 (72%) of the subjects with previous mild blood pressure elevation and 21 (73%) of the controls. We further analyzed possible associations between blood pressure level at follow-up and anthropometric data, and invasively measured hemodynamic variables at baseline. After 30 years, 38% in the group with blood pressure elevation at baseline had developed hypertension, as compared to 10% in the control group. There was a significant positive relationship between baseline systolic blood pressure (r = 0.56; p < 0.001) and diastolic blood pressure (r = 0.36; p < 0.01) and systolic blood pressure 30 years later. In further regression analyses, there were no associations between cardiac output, vascular resistance or anthropometric data at baseline and blood pressure at follow-up. In conclusion, casual blood pressure measurements predict the risk of future hypertension, whereas invasive hemodynamic and anthropometric measurements do not in young men with mild blood pressure elevation.