Isolated diastolic hypertension as defined by the 2017 American College of Cardiology/American Heart Association blood pressure guideline and incident cardiovascular events in Chinese.
J Hypertens
; 39(3): 519-525, 2021 03 01.
Article
en En
| MEDLINE
| ID: mdl-33031180
ABSTRACT
OBJECTIVE:
The new arterial hypertension guidelines by the 2017 American College of Cardiology (ACC)/American Heart Association (AHA) changed the definition of isolated diastolic hypertension (IDH). We assessed and compared in a Chinese population the IDH prevalence, newly defined by the 2017 ACC/AHA guidelines versus the former definition by the Joint National Committee 7 (JNC7) criteria, and examined longitudinal associations of IDH with cardiovascular disease (CVD) outcomes.METHODS:
The prospective community-based Kailuan Study included participants aged 18-98 years who underwent a detailed medical examination at baseline in 2006/2007 and who were biennially re-examined till 2017. History of antihypertensive medication at baseline was an exclusion criterion.RESULTS:
The study population consisted of 87â346 individuals (mean age 50.9 years; range 18-98 years). Prevalence of IDH was 7.79% [95% confidence interval (CI) 7.62, 7.97] by JNC7 guidelines and 24.72% (95% CI 24.43, 25.01) by 2017 ACC/AHA criteria [difference 19.93% (95% CI 16.81, 17.04)]. Applying the 2017 ACC/AHA guidelines, the prevalence of IDH-recommended antihypertensive therapy was 7.73% (95% CI 7.55, 7.90). In multivariable analysis, IDH by JNC7 criteria was significantly associated with incident myocardial infarction [nâ=â93 events; hazard ratio 1.30 (95 CI 1.02, 1.66)], cerebral hemorrhage [nâ=â73 events; hazard ratio 1.79 (95% CI 1.35, 2.38)], and total CVD [nâ=â373 events; hazard ratio 1.15 (95% CI 1.02, 1.30)], when compared with normotension. IDH based on 2017 ACC/AHA guidelines was associated with incident cerebral hemorrhage [nâ=â129 events; hazard ratio 1.47 (95% CI 1.12, 1.94)] and total CVD [nâ=â828 events; hazard ratio 1.13 (95% CI 1.02, 1.26)].CONCLUSION:
In this adult Chinese community, 2017 ACC/AHA-defined IDH was associated with the incidence of cerebral hemorrhage and total CVD, and as compared with JNC7-defined IDH, it was more prevalent.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Cardiología
/
Hipertensión
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
/
Guideline
/
Observational_studies
/
Prevalence_studies
/
Risk_factors_studies
Límite:
Adult
/
Humans
/
Middle aged
País/Región como asunto:
America do norte
/
Asia
Idioma:
En
Revista:
J Hypertens
Año:
2021
Tipo del documento:
Article
País de afiliación:
China