Prehypertension, all hypertension subtypes linked to increased CVD risk
MedWire News: Prehypertension and all hypertension subtypes, including isolated diastolic hypertension (IDH) are predictors for increased cardiovascular disease (CVD) risk, a study of patients in the Asia-Pacific region shows.
"Because a large portion of the population is classified as having prehypertension or hypertension, population strategies to lower blood pressure (BP) at the community level, such as salt reduction in commercial products, civil engineering to facilitate walking, and a systematic large-scale educational effort are essential for reduction in the global burden of CVD," say the authors.
Mark Woodward (University of Sydney, Australia) and team assessed the incidence of fatal and nonfatal CVD in 346,570 participants. The mean age of the participants at baseline was 48 years, 41% were women, and 78% were from Asia.
Overall, 38% of the participants had normal BP (<120/80 mmHg), 38% had prehypertension (120-139/80-89 mmHg), and 6% had IDH (<140/=90 mmHg). Eight percent of participants had isolated systolic hypertension (ISH; =140/<90 mmHg) and 11% had systolic-diastolic hypertension (=40/=90 mmHg).
During a mean follow-up period of 7 years, 8598 (2.5%) people experienced a CVD event, 3270 (0.9%) experienced coronary heart disease, 1503 (0.4%) experienced ischemic stroke, and 1015 (0.3%) experienced hemorrhagic stroke.
Cox analysis adjusted for age, cholesterol, and smoking, and stratified by gender and study showed that compared with individuals with normal BP, individuals with prehypertension had a 41% increased risk for CVD and those with IDH an 81% increased risk.
Individuals with ISH and systolic-diastolic hypertension had more than a twofold and threefold increased risk, respectively, for CVD compared with those who had a normal BP.
There were separate and significant associations observed for coronary heart disease, ischemic stroke, and hemorrhagic stroke across prehypertension and the different subtypes of hypertension.
"BP-lowering treatment should be initiated, and target BP levels recommended by current guidelines adopted, among all patients who require drug treatment, irrespective of hypertension subtype," the authors conclude in Hypertension.
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By Piriya Mahendra