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On-Treatment Blood Pressure and Cardiovascular Outcomes in Adults With Hypertension and Left Ventricular Hypertrophy

Authors
 Hyeok-Hee Lee  ;  Hokyou Lee  ;  So Mi Jemma Cho  ;  Dong-Wook Kim  ;  Sungha Park  ;  Hyeon Chang Kim 
Citation
 JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, Vol.78(15) : 1485-1495, 2021-10 
Journal Title
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
ISSN
 0735-1097 
Issue Date
2021-10
Keywords
cardiovascular risk ; hypertension ; left ventricular hypertrophy ; optimal blood pressure
Abstract
Background: Benefits of intensive blood pressure lowering on health outcomes have been demonstrated in high-risk patients. However, little is known about such benefits in patients with left ventricular hypertrophy (LVH). Objectives: This study sought to investigate the association of on-treatment blood pressure with cardiovascular disease (CVD) risk in adults with hypertension and LVH. Methods: From a nationwide health examination database, this study identified 95,545 participants aged 40-79 years who were taking antihypertensive medication and had LVH on baseline electrocardiography. Using Cox models, HRs and 95% CIs for CVD events were calculated according to systolic blood pressure (SBP) or diastolic blood pressure (DBP). Results: Over a median follow-up of 11.5 years, 12,035 new CVD events occurred. An SBP of <130 mm Hg and DBP of <80 mm Hg were associated with the lowest risk for CVD events in cubic spline models. When the group with SBP of 120-129 mm Hg was the reference, multivariable-adjusted HRs were 1.31 (95% CI: 1.24-1.38) in the ≥140 mm Hg group, 1.08 (95% CI: 1.02-1.15) in the 130-139 mm Hg group, and 1.03 (95% CI: 0.93-1.15) in the <120 mm Hg group. Likewise, when the group with DBP of 70-79 mm Hg was the reference, multivariable-adjusted HRs were 1.30 (95% CI: 1.24-1.37) in the ≥90 mm Hg group, 1.06 (95% CI: 1.01-1.12) in the 80-89 mm Hg group, and 1.08 (95% CI: 0.96 to 1.20) in the <70 mm Hg group. Conclusions: In adults with hypertension and LVH, the risk for CVD events was the lowest at SBP <130 mm Hg and DBP <80 mm Hg. Further randomized trials are warranted to establish optimal blood pressure-lowering strategies for these patients.
Full Text
https://www.sciencedirect.com/science/article/pii/S0735109721059143
DOI
10.1016/j.jacc.2021.08.015
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Others (기타) > 1. Journal Papers
Yonsei Authors
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
Lee, Hyeok-Hee(이혁희)
Lee, Hokyou(이호규) ORCID logo https://orcid.org/0000-0002-5034-8422
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/185949
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