Elevated On-Treatment Diastolic Blood Pressure and Cardiovascular Outcomes in the Presence of Achieved Systolic Blood Pressure Targetsopen access
- Authors
- Kim, Dae-Hee; Cho, In-Jeong; Kim, Woohyeun; Lee, Chan Joo; Kim, Hyeon-Chang; Shin, Jeong-Hun; Kang, Si-Hyuck; Jung, Mi-Hyang; Kwon, Chang Hee; Lee, Ju-Hee; Kim, Hack Lyoung; Kim, Hyue Mee; Cho, Iksung; Kang, Dae Ryong; Lee, Hae-Young; Chung, Wook-Jin; Kim, Kwang Il; Cho, Eun Joo; Sohn, Il-Suk; Park, Sungha; Shin, Jinho; Ryu, Sung Kee; Kang, Seok-Min; Pyun, Wook Bum; Cho, Myeong-Chan; Kim, Ju Han; Lee, Jun Hyeok; Ihm, Sang-Hyun; Sung, Ki-Chul
- Issue Date
- Jun-2022
- Publisher
- Korean Society of Circulation
- Keywords
- Blood pressure; Hypertension
- Citation
- Korean Circulation Journal, v.52, no.6, pp.460 - 474
- Indexed
- SCIE
SCOPUS
KCI
- Journal Title
- Korean Circulation Journal
- Volume
- 52
- Number
- 6
- Start Page
- 460
- End Page
- 474
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/170127
- 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.
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