Abstract
To describe the association between mean blood pressure (BP) and clinical outcomes and to investigate the optimal BP in elderly hypertensive subjects. This study used the National Health Insurance Service health examinee cohort. Subjects aged >60 years with a new diagnosis of hypertension from 2003 to 2006 were selected. Patients with previous major cardiovascular events were excluded. The remaining 23,523 subjects were divided into three groups according to the average of the observed systolic BP (SBP) and diastolic BP (DBP): (i) average SBP <130 mm Hg (n = 6,893), 130-140 mm Hg (n = 8,676), and ≥140 mm Hg (n = 7,954) or (ii) average DBP <80 mm Hg (n = 9,273), 80-90 mm Hg (n = 11,607), and ≥90 mm Hg (n = 2,643). Compared with SBP ≥140 mm Hg, SBP 130-140 mm Hg was associated with significantly lower rates of all-cause mortality (hazard ratio (HR) = 0.69, 95% confidence interval (CI) = 0.62-0.76, P < 0.001) and cardiovascular mortality (HR = 0.61, 95% CI = 0.50-0.75, P < 0.001). However, SBP <130 mm Hg did not show further lowering of all-cause and cardiovascular mortality rates compared with SBP 130-140 mm Hg. DBP 80-90 mm Hg was also associated with lower risks of all-cause death (HR = 0.64, 95% CI = 0.57-0.72, P < 0.001) and ...Continue Reading
References
Jan 23, 1991·JAMA : the Journal of the American Medical Association·L FarnettM R Tuley
Jun 26, 1991·JAMA : the Journal of the American Medical Association
Nov 1, 1993·Circulation·R V LuepkerH Blackburn
Sep 23, 1997·Lancet·J A StaessenA Zanchetti
Nov 5, 2003·Annals of Internal Medicine·Roberto Pastor-BarriusoEliseo Guallar
Mar 17, 2005·Circulation·George A MensahJanet B Croft
Jun 21, 2006·Annals of Internal Medicine·Franz H MesserliCarl J Pepine
Jan 24, 2008·Circulation·Ralph B D'AgostinoWilliam B Kannel
Oct 31, 2008·Pharmacoepidemiology and Drug Safety·Peter C Austin
Jan 14, 2009·Hypertension Research : Official Journal of the Japanese Society of Hypertension·UNKNOWN JATOS Study Group
Jun 10, 2009·Journal of Hypertension·Peter SleightUNKNOWN ONTARGET investigators
Dec 30, 2009·Hypertension·Martin G MyersJanusz Kaczorowski
Jun 10, 2010·Hypertension·Toshio OgiharaUNKNOWN Valsartan in Elderly Isolated Systolic Hypertension Study Group
Nov 18, 2011·JAMA : the Journal of the American Medical Association·Bruce OvbiageleUNKNOWN PROFESS Investigators
Mar 19, 2015·BMJ Open·Mark WoodwardUNKNOWN Asia Pacific Cohort Studies Collaboration
Sep 1, 2015·The Canadian Journal of Cardiology·Saswata DebStephen E Fremes
Nov 10, 2015·The New England Journal of Medicine·UNKNOWN SPRINT Research GroupWalter T Ambrosius
Feb 26, 2016·Diabetes & Metabolism Journal·Yong Ho LeeUNKNOWN Taskforce Team of Diabetes Fact Sheet of the Korean Diabetes Association
May 20, 2016·JAMA : the Journal of the American Medical Association·Jeff D WilliamsonUNKNOWN SPRINT Research Group
Jan 5, 2017·Hypertension·Yuichiro YanoToshio Ogihara
Mar 1, 2017·Hypertension·Fangfang FanYong Huo
Nov 15, 2017·Hypertension·David M ReboussinSuma Vupputuri