Elevated On-Treatment Diastolic Blood Pressure and Cardiovascular Outcomes in the Presence of Achieved Systolic Blood Pressure Targets
- Authors
- Kim, D.-H.; Cho, I.-J.; Kim, W.; Lee, C.J.; Kim, H.-C.; Shin, J.-H.; Kang, S.-H.; Jung, M.-H.; Kwon, C.H.; Lee, J.-H.; Kim, H.L.; Kim, H.M.; Cho, I.; Kang, D.R.; Lee, H.-Y.; Chung, W.-J.; Kim, K.I.; Cho, E.J.; Sohn, I.-S.; Park, S.; Shin, J.; Ryu, S.K.; Kang, S.-M.; Pyun, W.B.; Cho, M.-C.; Kim, J.H.; Lee, J.H.; Ihm, S.-H.; Sung, K.-C.
- Issue Date
- Jun-2022
- Publisher
- Korean Society of Circulation
- Keywords
- Blood pressure; Hypertension
- Citation
- Korean Circulation Journal, v.52, no.6, pp.460 - 474
- Journal Title
- Korean Circulation Journal
- Volume
- 52
- Number
- 6
- Start Page
- 460
- End Page
- 474
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/84755
- DOI
- 10.4070/kcj.2021.0330
- ISSN
- 1738-5520
- Abstract
- Background and Objectives: This study aimed to investigate the association between cardiovascular events and 2 different levels of elevated on-treatment diastolic blood pressures (DBP) in the presence of achieved systolic blood pressure targets (SBP). Methods: A nation-wide population-based cohort study comprised 237,592 patients with hypertension treated. The primary endpoint was a composite of cardiovascular death, myocardial infarction, and stroke. Elevated DBP was defined according to the Seventh Report of Joint National Committee (JNC7; SBP <140 mmHg, DBP ≥90 mmHg) or to the 2017 American College of Cardiology/American Heart Association (ACC/AHA) definitions (SBP <130 mmHg, DBP ≥80 mmHg). Results: During a median follow-up of 9 years, elevated on-treatment DBP by the JNC7 definition was associated with an increased risk of the occurrence of primary endpoint compared with achieved both SBP and DBP (adjusted hazard ratio [aHR], 1.14; 95% confidence interval [CI], 1.05-1.24) but not in those by the 2017 ACC/AHA definition. Elevated on-treatment DBP by the JNC7 definition was associated with a higher risk of cardiovascular mortality (aHR, 1.42; 95% CI, 1.18-1.70) and stroke (aHR, 1.19; 95% CI, 1.08-1.30). Elevated on-treatment DBP by the 2017 ACC/AHA definition was only associated with stroke (aHR, 1.10; 95% CI, 1.04-1.16). Similar results were seen in the propensity-score-matched cohort. Conclusion: Elevated on-treatment DBP by the JNC7 definition was associated a high risk of major cardiovascular events, while elevated DBP by the 2017 ACC/AHA definition was only associated with a higher risk of stroke. The result of study can provide evidence of DBP targets in subjects who achieved SBP targets. © 2022 Korean Society of Circulation. All rights reserved.
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