High systolic BP in middle-aged women raises CV event risk
MedWire News: Having systolic hypertension may increase the risk for cardiovascular (CV) events in women aged 50 years or older, researchers report.
Therefore, stringent treatment and control of blood pressure (BP) is an important CV disease prevention strategy among middle-aged women, say Jan Staessen (Universidad de la República, Montevideo, Uruguay) and team.
"I was surprised by the study findings that highlight the missed opportunities for prevention of heart disease in older women," commented Staessen. "We found that a 15-mmHg increase in systolic BP increased the risk for CV disease by 56% in women compared to 32% in men."
The team assessed the occurrence of CV events among 9358 European, Asian, and South American participants (47% women) with a mean age of 53 years. Night-time and 24-hour ambulatory BP measurements were taken from all participants, and conventional BP measurement (on one occasion in a clinic setting) at baseline identified 3866 hypertensive participants (systolic BP >140 mmHg).
Among the participants, the mean systolic BP was higher when BP was measured conventionally than when measured over 24-hours, at 130.4 and 123.7 mmHg, respectively.
After a follow-up period of 11 years, 1245 deaths occurred, of which 472 were due to CV causes. In addition, 1080 CV events, 525 cardiac events, and 458 strokes occurred during this period.
As reported in the journal Hypertension, the researchers found that both men and women had increasing CV event risks with increasing ambulatory and conventional BP levels.
The team observed a 38% higher overall risk for CV events and a 34% higher risk for death among men compared with women (p<0.001).
In contrast, the risk of CV events in relation to systolic BP was more pronounced among women than men, resulting in a significantly higher percentage of preventable CV events associated with systolic BP among women compared with men.
Specifically, each 13.4 mmHg decrease in systolic BP was equivalent to respective reductions in preventable CV events of 35.9% and 24.2% in women and men (p=0.021) when 24-hour BP measurements were considered, and respective reductions of 35.1% and 19.4% when night-time BP measurements were used (p=0.027).
In a related editorial, Bernard Waeber and Michel Burnier, both from the University of Lausanne in Switzerland, acknowledged: "The difference in the relation of night-time BP to CV complications in men and women... remains largely unexplained."
Nonetheless, Staessen and colleagues conclude that the use of ambulatory BP measurements in the diagnosis and monitoring of hypertension "will help women live a longer life with higher quality."
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By Lauretta Ihonor