Findings highlight risks of prehypertension.

Bruce Ovbiagele, UC San Diego

People with prehypertension have a 55 percent higher risk of experiencing a future stroke than people without prehypertension, report researchers at the University of California, San Diego, School of Medicine in a new meta-analysis of scientific literature published in today’s (Sept. 28) online issue of the journal Neurology.

Prehypertension is a clinical category created by experts in 2003 to describe patients whose blood pressure was elevated, but still considered within normal range. Hypertension or abnormally high blood pressure is a major risk factor for cardiovascular disease and strokes, but much less is known about the health threat posed of prehypertension, which is defined by a systolic pressure reading between 120 and 139 mmHg (the top number) and a diastolic reading between 80 and 89 mm Hg (the bottom number)

“The experts reasoned that, generally speaking, the higher the blood pressure, the greater the risk of death and disease, possibly starting from within the normal blood range,” said Bruce Ovbiagele, M.D., professor of neurosciences at UC San Diego School of Medicine and senior author of the study.

However, Ovbiagele said, conclusive evidence was lacking, “so we decided to compile all the published studies in the scientific literature to date, and using statistical techniques find out if there is indeed a higher risk of future stroke in people with prehypertension, the extent of that risk, and whether particular characteristics were associated with higher stroke risk.”

The researchers identified 12 relevant prospective cohort studies of prehypertension. All of the studies were derived from the general population. Four were from the United States, five from Japan, two from China and one from India. Combined, the studies involved more than 518,000 participants and covered periods ranging from 2.7 years to 32 years, with stroke occurrences documented. The prevalence of prehypertension in the studies ranged from 25 to 46 percent. In the United States, it’s estimated roughly one-third of adults have prehypertension.

“Overall, people who had prehypertension (in the studies) were at a 55 percent higher risk of experiencing a future stroke than people without prehypertension,” said Ovbiagele. “This result held regardless of sex, race-ethnicity, blood pressure type (systolic or diastolic) or the type of stroke (ischemic or hemorrhagic).”

The health risk was measurably greater for those whose blood pressure levels were at the high end of the “normal” spectrum. “We found that those people who fell within the higher range of prehypertension were at 79 percent higher risk of experiencing a future stroke,” Ovbiagele said.

Read more

Study makes “strong case that psoriasis is not just a skin-deep disease.”

April Armstrong, UC Davis

UC Davis dermatologists have found that people who have high blood pressure as well as psoriasis – a condition that causes patches of irritated, itchy red skin – are more likely to have more severe high blood pressure and require more medications to control it than people without psoriasis. The association between high blood pressure (hypertension) and psoriasis is an active area of investigation, but this is the first study to suggest a link between the dermatological condition and hypertension severity.

The findings are reported in the article, “Psoriasis and Hypertension Severity: Results from a Case-Control Study,” which is now available online in PLoS ONE, the open-access journal for the communication of peer-reviewed scientific and medical research.

“Our study makes a strong case that psoriasis is not just a skin-deep disease,” said April W. Armstrong, assistant clinical professor of dermatology and principal investigator and lead author of the study. “We are beginning to find that psoriasis may represent a window into detecting cardiovascular conditions, including hypertension.”

Psoriasis affects about 4 percent of the U.S. population and causes patches of itchy, thickened, dry, reddened skin. It is passed down in families and is believed to be caused by a person’s immune system mistakenly attacking one’s own skin cells. The severity of the condition varies considerably among individuals and over time. It often flares up during dry weather or with infections.

“The study’s findings can alert primary-care providers, cardiologists and nephrologists, all of whom frequently treat hypertension,” said Armstrong. “Hypertensive patients who also have psoriasis are likely to need closer monitoring and a more aggressive drug regimen to achieve adequate blood-pressure control.”

Read more

Researchers at UC San Diego have identified a key protein that promotes the development of pulmonary arterial hypertension in humans and mice. This groundbreaking discovery has implications for future drug therapies that may extend the life of patients with pulmonary arterial hypertension and prevent the need for lung transplantation, currently the only cure for this debilitating disease.

In a paper to be published online in Nature Medicine on October 25, Patricia Thistlethwaite, MD, PhD, Professor of Surgery and cardiothoracic surgeon in UCSD’s Department of Surgery, and colleagues describe the genetic pathway by which vascular smooth muscle cells associated with pulmonary arterial hypertension are switched on to proliferate by a receptor protein called Notch-3. With this finding, the researchers were able to block and reverse the pathway of disease in mice.

Read more