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

Authors
 Jiwon Seo  ;  Chan Joo Lee  ;  Jinseub Hwang  ;  Jaewon Oh  ;  Sang-Hak Lee  ;  Seok-Min Kang  ;  Donghoon Choi  ;  Hyeon-Chang Kim  ;  Sungha Park 
Citation
 American Journal of Hypertension, Vol.31(9) : 1033-1041, 2018 
Journal Title
 American Journal of Hypertension 
ISSN
 0895-7061 
Issue Date
2018
Keywords
antihypertensive treatment ; blood pressure ; elderly ; hypertension
Abstract
BACKGROUND: To describe the association between mean blood pressure (BP) and clinical outcomes and to investigate the optimal BP in elderly hypertensive subjects. METHODS: 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). RESULTS: 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 cardiovascular death (HR = 0.51, 95% CI = 0.40-0.64, P < 0.001) compared with DBP ≥90 mm Hg. There were no additional benefits with DBP <80 mm Hg for all-cause death and cardiovascular death. CONCLUSIONS: Mean BP of <140/90 mm Hg were associated with lowest all-cause and cardiovascular mortality without any further benefit with mean BP <130/80 mm Hg.
Full Text
https://academic.oup.com/ajh/article/31/9/1033/4996238
DOI
10.1093/ajh/hpy081
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 and Public Health (예방의학교실) > 1. Journal Papers
Yonsei Authors
강석민(Kang, Seok Min) ORCID logo https://orcid.org/0000-0001-9856-9227
김현창(Kim, Hyeon Chang) ORCID logo https://orcid.org/0000-0001-7867-1240
박성하(Park, Sung Ha) ORCID logo https://orcid.org/0000-0001-5362-478X
서지원(Seo, Jiwon) ORCID logo https://orcid.org/0000-0002-7641-3739
오재원(Oh, Jae Won) ORCID logo https://orcid.org/0000-0002-4585-1488
이상학(Lee, Sang Hak) ORCID logo https://orcid.org/0000-0002-4535-3745
최동훈(Choi, Dong Hoon) ORCID logo https://orcid.org/0000-0002-2009-9760
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/163217
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