Clinical Edge

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Modifiable Risk Factors in New BP Categories

Am J Med; ePub 2018 Jul 26; Gu, Yue, et al

Among untreated adults, the burden of potentially modifiable risk factors for hypertension shows progressive increase along newly-defined pressure (BP) categories from the 2017 American College of Cardiology/American Heart Association (ACC/AHA) guidelines, a recent study found. Researchers analyzed data from the 1999-2014 National Health and Examination Survey (NHANES, n=37,448). Potentially modifiable risk factors included abdominal obesity, high non-HDL-cholesterol, secondhand smoking, binge drinking, suboptimal physical activity (PA), and low fiber diet. They found:

  • The prevalence of certain modifiable risk factors decreased during the study period.
  • However, the prevalence of low fiber intake, suboptimal PA, abdominal obesity, and binge drinking remined high during the last combined survey cycle.
  • Modifiable risk factors generally demonstrated dose-response relationships with high BP categories.
  • The most common type of risk factor clustering included low fiber intake, suboptimal PA, high non-HDL cholesterol and abdominal obesity, with its prevalence increasing gradually from 9.5% in the normal BP group to 16.5% in the state 2 hypertension group.
  • The prevalence of ≥4 modifiable risk factors per participant increased stepwise.


Gu A, Yue Y, Kim J, Argulian E. The burden of modifiable risk factors in newly defined categories of blood pressure. [Published online ahead of print July 26, 2018]. Am J Med. doi:10.1016/j.amjmed.2018.06.030.

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