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Elevated On-Treatment Diastolic Blood Pressure and Cardiovascular Outcomes in the Presence of Achieved Systolic Blood Pressure Targets
- Title
- 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.
- Ewha Authors
- 편욱범; 조인정
- SCOPUS Author ID
- 편욱범; 조인정
- Issue Date
- 2022
- Journal Title
- Korean Circulation Journal
- ISSN
- 1738-5520
- Citation
- Korean Circulation Journal vol. 52
- Keywords
- Blood pressure; Hypertension
- Publisher
- Korean Society of Circulation
- Indexed
- SCIE; SCOPUS; KCI
- Document Type
- Article
- 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.
- DOI
- 10.4070/kcj.2021.0330
- Appears in Collections:
- 의과대학 > 의학과 > Journal papers
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