TY - JOUR
T1 - Is systolic blood pressure below 150 mm Hg an appropriate goal for primary prevention of cardiovascular events among elderly population?
AU - Mohebi, Reza
AU - Mohebi, Ali
AU - Ghanbarian, Arash
AU - Momenan, Amirabbas
AU - Azizi, Fereidoun
AU - Hadaegh, Farzad
N1 - Funding Information:
Grant Support: This study was supported by Grant number 121 from the National Research Council of the Islamic Republic of Iran .
PY - 2014/7
Y1 - 2014/7
N2 - Recently, Joint National Committee has changed the optimal therapeutic goal of systolic blood pressure (SBP) up to 150 mm Hg for elderly population. We aimed to investigate impact of different blood pressure (BP) categories on risk of developing cardiovascular disease (CVD) and mortality among elderly. The present study included 1845 participants, aged ≥60 years (mean age = 65 years), free of CVD at baseline, who had undergone health examinations between January 1999 and 2001, and were followed up until March 2010. Cox proportional hazard regression was performed to assess the hazard ratios (HRs) of BP categories for CVD and mortality events, considering those with optimal BP (SBP <120 mm Hg and diastolic BP [DBP] <80 mm Hg) as reference. During a median of 10 years follow-up, 380 cases of first CVD and 260 cases of mortality events occurred. In multivariable adjusted model, prehypertensive group (SBP between 120-129 mm Hg or DBP between 80-85 mm Hg) could not predict CVD (HR, 0.87 [0.61-1.24]) nor mortality events (HR, 0.86 [0.58-1.34]). Those with SBP between 140 mm Hg and 150 mm Hg (group 3) were at higher risk for developing CVD (HR, 1.79 [1.17-2.74]), but there were no significant risk for total mortality (HR, 1.13 [0.65-1.97]). Hypertensive group (SBP ≥150 mm Hg or DBP ≥90 mm Hg or taking antihypertensive drugs) was associated with increased risk of both CVD (HR, 1.73 [1.24-2.42]) and mortality events (HR, 1.49 [1.00-2.23]).However, Joint National Committee 8 suggested no more benefit with lowering SBP <150 mm Hg, but the results of this study imply that those with SBP between 150 mm Hg and 140 mm Hg are still at elevated risk for CVD/coronary heart disease events.
AB - Recently, Joint National Committee has changed the optimal therapeutic goal of systolic blood pressure (SBP) up to 150 mm Hg for elderly population. We aimed to investigate impact of different blood pressure (BP) categories on risk of developing cardiovascular disease (CVD) and mortality among elderly. The present study included 1845 participants, aged ≥60 years (mean age = 65 years), free of CVD at baseline, who had undergone health examinations between January 1999 and 2001, and were followed up until March 2010. Cox proportional hazard regression was performed to assess the hazard ratios (HRs) of BP categories for CVD and mortality events, considering those with optimal BP (SBP <120 mm Hg and diastolic BP [DBP] <80 mm Hg) as reference. During a median of 10 years follow-up, 380 cases of first CVD and 260 cases of mortality events occurred. In multivariable adjusted model, prehypertensive group (SBP between 120-129 mm Hg or DBP between 80-85 mm Hg) could not predict CVD (HR, 0.87 [0.61-1.24]) nor mortality events (HR, 0.86 [0.58-1.34]). Those with SBP between 140 mm Hg and 150 mm Hg (group 3) were at higher risk for developing CVD (HR, 1.79 [1.17-2.74]), but there were no significant risk for total mortality (HR, 1.13 [0.65-1.97]). Hypertensive group (SBP ≥150 mm Hg or DBP ≥90 mm Hg or taking antihypertensive drugs) was associated with increased risk of both CVD (HR, 1.73 [1.24-2.42]) and mortality events (HR, 1.49 [1.00-2.23]).However, Joint National Committee 8 suggested no more benefit with lowering SBP <150 mm Hg, but the results of this study imply that those with SBP between 150 mm Hg and 140 mm Hg are still at elevated risk for CVD/coronary heart disease events.
KW - Coronary heart disease
KW - hypertension
KW - mortality
KW - stroke
KW - treatment
UR - http://www.scopus.com/inward/record.url?scp=84905190743&partnerID=8YFLogxK
U2 - 10.1016/j.jash.2014.04.010
DO - 10.1016/j.jash.2014.04.010
M3 - Article
C2 - 25064771
AN - SCOPUS:84905190743
SN - 1933-1711
VL - 8
SP - 491
EP - 497
JO - Journal of the American Society of Hypertension
JF - Journal of the American Society of Hypertension
IS - 7
ER -