Optimal Blood Pressure in Elderly Hypertensive Subjects: A Korean National Health Insurance Service Health Examinee Cohort Study

American Journal of Hypertension
Jiwon SeoSungha Park

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

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Citations

Jan 5, 2019·Circulation Journal : Official Journal of the Japanese Circulation Society·Sang-Hyun IhmKwang Kon Koh

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