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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
편욱범조인정
SCOPUS Author ID
편욱범scopus; 조인정scopus
Issue Date
2022
Journal Title
Korean Circulation Journal
ISSN
1738-5520JCR Link
Citation
Korean Circulation Journal vol. 52
Keywords
Blood pressureHypertension
Publisher
Korean Society of Circulation
Indexed
SCIE; SCOPUS; KCI WOS scopus
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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