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Relation Between Blood Pressure and Clinical Outcome in Hypertensive Subjects With Previous Str

Authors
 Chan Joo Lee  ;  Jinseub Hwang  ;  Jaewon Oh  ;  Sang‐Hak Lee  ;  Seok‐Min Kang  ;  Hyeon Chang Kim  ;  Sungha Park 
Citation
 JOURNAL OF THE AMERICAN HEART ASSOCIATION, Vol.6(12) : e007102, 2017 
Journal Title
JOURNAL OF THE AMERICAN HEART ASSOCIATION
Issue Date
2017
Keywords
hypertension ; mortality ; myocardial infarction ; stroke
Abstract
BACKGROUND: This study investigated whether a mean blood pressure (BP) of <130/80 mm Hg is associated with further reduction in cardiovascular outcomes in treated hypertensive subjects with previous stroke.

METHODS AND RESULTS: Subjects from the Korea National Health Insurance Service health examinee cohort diagnosed as having stroke and hypertension from January 1st, 2003 and December 31st, 2006 (N=2320) were grouped according to mean systolic (<130, 130-<140, and ≥140 mm Hg) and diastolic (<80, 80-<90, and ≥90 mm Hg) BP recorded during follow-up health examinations. All-cause and cardiovascular mortality over 11 years were compared. Compared with subjects with a systolic BP of ≥140 mm Hg (N=736), subjects with a systolic BP of 130 to <140 mm Hg (N=793) had a significantly lower risk of all-cause death (hazard ratio [HR], 0.61; 95% confidence interval [CI], 0.47-0.79; P<0.001), cardiovascular mortality (HR, 0.39; 95% CI, 0.25-0.61; P<0.001), and fatal ischemic stroke (HR, 0.25; 95% CI, 0.10-0.63; P=0.003). Systolic BP of <130 mm Hg (N=791) was associated with lower risk of nonfatal hemorrhagic stroke. Subjects with a diastolic BP of 80 to <90 mm Hg (N=1100) had significantly lower risk of all-cause death (HR, 0.60, 95% CI, 0.45-0.80; P<0.001) and cardiovascular mortality (HR, 0.45; 95% CI, 0.30-0.70; P<0.001) than those with a diastolic BP of ≥90 mm Hg (N=342). Diastolic BP of <80 mm Hg (N=878) was associated with reduced risk of nonfatal hemorrhagic stroke and further lowering of all-cause mortality and cardiovascular mortality.

CONCLUSIONS: BP of <130/80 mm Hg was associated with improved outcomes in hypertensive subjects with previous stroke.
Files in This Item:
T201704924.pdf Download
DOI
10.1161/JAHA.117.007102
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Preventive Medicine (예방의학교실) > 1. Journal Papers
Yonsei Authors
Kang, Seok Min(강석민) ORCID logo https://orcid.org/0000-0001-9856-9227
Kim, Hyeon Chang(김현창) ORCID logo https://orcid.org/0000-0001-7867-1240
Park, Sung Ha(박성하) ORCID logo https://orcid.org/0000-0001-5362-478X
Oh, Jae Won(오재원) ORCID logo https://orcid.org/0000-0002-4585-1488
Lee, Sang Hak(이상학) ORCID logo https://orcid.org/0000-0002-4535-3745
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/161483
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