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Clinical Benefit of Treatment of Stage-1, Low-Risk Hypertension: Korean National Health Insurance Database Analysis
- Clinical Benefit of Treatment of Stage-1, Low-Risk Hypertension: Korean National Health Insurance Database Analysis
- Lee, Chan Joo; Ryu, Jiin; Kim, Hyeon-Chang; Ryu, Dong-Ryeol; Ihm, Sang-Hyun; Kim, Yong-Jin; Shin, Jin-Ho; Pyun, Wook Bum; Kang, Hyoung-Soo; Park, Jong-Heon; Hwang, Jinseub; Park, Sungha
- Ewha Authors
- 편욱범; 류동열
- SCOPUS Author ID
- 편욱범; 류동열
- Issue Date
- Journal Title
- HYPERTENSION vol. 72, no. 6, pp. 1285 - 1293
- blood pressure; hypertension; mortality; myocardial infarction; stroke
- LIPPINCOTT WILLIAMS &
- SCIE; SCOPUS
- Document Type
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- Evidence about the benefits of treating uncomplicated, low-risk, stage-1 hypertension is lacking. The study aimed to investigate the association between mean blood pressure (BP) and clinical outcomes, and to determine optimal BPs in treated, low-risk, stage-1 hypertension. From the National Health Insurance Service Health Examination Database, patients with stage-1 hypertension between 2005 and 2006 were selected. They had a systolic BP of 140 to 159 mmHg or diastolic BP of 90 to 99 mmHg. Patients were grouped as controlled (mean BP <140/90 mmHg; n=99301) and uncontrolled (mean BP 140/90 mmHg; n=49460) according to their mean BP recorded during the follow-up health examination. All-cause mortality and cardiovascular outcomes were examined. Mean BPs in the controlled and uncontrolled groups were 131.1/80.9 and 144.6/86.8 mmHg, respectively. Controlled BP was associated with significantly lower risks of all-cause mortality, all stroke, hemorrhagic stroke, ischemic stroke, and end-stage renal disease. Subgroup analysis demonstrated benefits of controlled BP in hypertensive patients aged <50 years for all-cause mortality, all stroke, hemorrhagic stroke, ischemic stroke, and end-stage renal disease, with no significant interaction according to age. The BP associated with the lowest risk of all-cause mortality was 120 to <130 mmHg (systolic BP) and 70 to <80 mmHg (diastolic BP). There was an increased risk of myocardial infarction in patients with mean systolic BP <120 mmHg and diastolic BP <80 mmHg. BP <140/90 mmHg was associated with a significant reduction in the risk of mortality, stroke, and end-stage renal disease, with the lowest mortality risk at BP ranges of 120 to <130 and 70 to <80 mmHg.
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