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Reduction in blood pressure for elevated blood pressure/stage 1 hypertension according to the American College of Cardiology/American Heart Association guideline and cardiovascular outcomes.

Publication ,  Journal Article
Kaneko, H; Yano, Y; Suzuki, Y; Okada, A; Itoh, H; Matsuoka, S; Fujiu, K; Michihata, N; Jo, T; Takeda, N; Morita, H; Node, K; Viera, AJ ...
Published in: Eur J Prev Cardiol
October 20, 2022

AIMS: Few studies have examined the relationship of blood pressure (BP) change in adults with elevated BP or stage 1 hypertension according to the American College of Cardiology (ACC)/American Heart Association (AHA) guideline with cardiovascular outcomes. We sought to identify the effect of BP change among individuals with elevated BP or stage 1 hypertension on incident heart failure (HF) and other cardiovascular diseases (CVDs). METHODS AND RESULTS: We conducted a retrospective cohort study including 616 483 individuals (median age 46 years, 73.7% men) with elevated BP or stage 1 hypertension based on the ACC/AHA BP guideline. Participants were categorized using BP classification at one-year as normal BP (n = 173 558), elevated BP/stage 1 hypertension (n = 367 454), or stage 2 hypertension (n = 75 471). The primary outcome was HF, and the secondary outcomes included (separately) myocardial infarction (MI), angina pectoris (AP), and stroke. Over a mean follow-up of 1097 ± 908 days, 10 544 HFs, 1317 MIs, 11 070 APs, and 5198 strokes were recorded. Compared with elevated BP/stage 1 hypertension at one-year, normal BP at one-year was associated with a lower risk of developing HF [hazard ratio (HR): 0.89, 95% CI:0.85-0.94], whereas stage 2 hypertension at one-year was associated with an elevated risk of developing HF (HR:1.43, 95% CI:1.36-1.51). This association was also present in other cardiovascular outcomes including MI, AP, and stroke. The relationship was consistent in all subgroups stratified by age, sex, baseline BP category, and overweight/obesity. CONCLUSION: A one-year decline in BP was associated with the lower risk of HF, MI, AP, and stroke, suggesting the importance of lowering BP in individuals with elevated BP or stage 1 hypertension according to the ACC/AHA guideline to prevent the risk of developing CVD.

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Published In

Eur J Prev Cardiol

DOI

EISSN

2047-4881

Publication Date

October 20, 2022

Volume

29

Issue

14

Start / End Page

1921 / 1929

Location

England

Related Subject Headings

  • United States
  • Stroke
  • Retrospective Studies
  • Myocardial Infarction
  • Middle Aged
  • Male
  • Hypertension
  • Humans
  • Female
  • Cardiology
 

Citation

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Kaneko, H., Yano, Y., Suzuki, Y., Okada, A., Itoh, H., Matsuoka, S., … Komuro, I. (2022). Reduction in blood pressure for elevated blood pressure/stage 1 hypertension according to the American College of Cardiology/American Heart Association guideline and cardiovascular outcomes. Eur J Prev Cardiol, 29(14), 1921–1929. https://doi.org/10.1093/eurjpc/zwac193
Kaneko, Hidehiro, Yuichiro Yano, Yuta Suzuki, Akira Okada, Hidetaka Itoh, Satoshi Matsuoka, Katsuhito Fujiu, et al. “Reduction in blood pressure for elevated blood pressure/stage 1 hypertension according to the American College of Cardiology/American Heart Association guideline and cardiovascular outcomes.Eur J Prev Cardiol 29, no. 14 (October 20, 2022): 1921–29. https://doi.org/10.1093/eurjpc/zwac193.
Kaneko, Hidehiro, et al. “Reduction in blood pressure for elevated blood pressure/stage 1 hypertension according to the American College of Cardiology/American Heart Association guideline and cardiovascular outcomes.Eur J Prev Cardiol, vol. 29, no. 14, Oct. 2022, pp. 1921–29. Pubmed, doi:10.1093/eurjpc/zwac193.
Kaneko H, Yano Y, Suzuki Y, Okada A, Itoh H, Matsuoka S, Fujiu K, Michihata N, Jo T, Takeda N, Morita H, Node K, Viera AJ, Lima JAC, Oparil S, Lam CSP, Carey RM, Yasunaga H, Komuro I. Reduction in blood pressure for elevated blood pressure/stage 1 hypertension according to the American College of Cardiology/American Heart Association guideline and cardiovascular outcomes. Eur J Prev Cardiol. 2022 Oct 20;29(14):1921–1929.
Journal cover image

Published In

Eur J Prev Cardiol

DOI

EISSN

2047-4881

Publication Date

October 20, 2022

Volume

29

Issue

14

Start / End Page

1921 / 1929

Location

England

Related Subject Headings

  • United States
  • Stroke
  • Retrospective Studies
  • Myocardial Infarction
  • Middle Aged
  • Male
  • Hypertension
  • Humans
  • Female
  • Cardiology