Development of blood pressure and the incidence of hypertension in men andwomen over an 18 year period: Results-of the Nijmegen Cohort Study

The objective of this study was to determine the factors that influence dia stolic blood pressure (DBP) and the incidence of hypertension. In 1977, DBP and cardiovascular risk factors were measured in 7092 men and women. In 19 95, 2335 subjects participated at a second screening. Those patients alread y under hypertension treatment in 1977 were excluded. The DBP tracking was studied in subjects not under hypertension treatment during the study. Hype rtension was defined on two ways in the analysis: under current hypertensio n treatment or a DBP > 95 mmHg measured at rescreening in 1995. Forty-seven percent of the subjects with a DBP < 75 mmHg in 1977 remained in the same category of DBP in 1995, and 7% had become hypertensive. Of the 75-84 mmHg group in 1977, 40% stayed in the same category in 1995 and 15% became hyper tensive. Of the 85-94 mmHg category, 30% stayed in the same category and 30 % became hypertensive in 1995. Of the highest category in 1977 (> 95 mmHg), 64% were still in that category in 1995. Baseline DBP in 1977 had the high est predictive value for future DBP. Weight gain over the years increased t he risk for future hypertension: in contrast, there was no risk at a low DB P without weight gain. There is no need for regular check-ups for those pat ients with a low DBP who experience no weight gain. Borderline DBP (85-95 m mHg), together with weight gain, increases the risk of development of hyper tension. The risk was especially high for men in the lower socioeconomic cl ass. (C) 1999 Elsevier Science Inc.