Isolated diastolic hypertension and incident heart failure in community-dwelling older adults: Insights from the Cardiovascular Health Study.
Isolated diastolic hypertension and incident heart failure in community-dwelling older adults: Insights from the Cardiovascular Health Study.
- 2017
BACKGROUND: Isolated systolic hypertension and isolated diastolic hypotension are common in older adults and associated with a higher risk of incident heart failure (HF). However, little is known about the prevalence and impact of isolated diastolic hypertension in this population. CONCLUSION: Among community-dwelling older adults, isolated diastolic hypertension is rare and is associated with higher risk for incident HF and cardiovascular mortality. Copyright Published by Elsevier B.V. METHODS: In the Cardiovascular Health Study (CHS), of the 5776 community-dwelling older adults >65years who had data on baseline systolic and diastolic blood pressure (SBP and DBP), 28 had isolated diastolic hypertension (DBP >90mmHg and SBP <140mmHg). From the 5748 without isolated diastolic hypertension, we excluded those with SBP >120mmHg (n=4451), DBP 80-89mmHg (n=20), DBP <60mmHg (n=425), normal BP taking anti-hypertensive medications (n=311), normal BP taking no anti-hypertensive medications but with history of hypertension (n=38), and baseline HF (n=5). The final cohort of 524 participants included 27 with isolated diastolic hypertension. RESULTS: Patients (n=524) had a mean (+/-SD) age of 71 (+/-5) years, 58% were women and 9% African American. There were no significant between-group age or sex differences; 37% of those with isolated diastolic hypertension (versus 7% without) were African American. Incident HF occurred in 19% and 7% of participants with and without isolated diastolic hypertension, respectively (multivariable-adjusted hazard ratio , 4.65; 95% confidence interval , 1.09-19.90; p=0.038). There was a trend toward higher cardiovascular mortality (HR, 4.59; 95% CI, 0.92-23.88; p=0.063).
English
0167-5273
IN PROCESS -- NOT YET INDEXED
MedStar Washington Hospital Center
Medicine/Internal Medicine
Journal Article
BACKGROUND: Isolated systolic hypertension and isolated diastolic hypotension are common in older adults and associated with a higher risk of incident heart failure (HF). However, little is known about the prevalence and impact of isolated diastolic hypertension in this population. CONCLUSION: Among community-dwelling older adults, isolated diastolic hypertension is rare and is associated with higher risk for incident HF and cardiovascular mortality. Copyright Published by Elsevier B.V. METHODS: In the Cardiovascular Health Study (CHS), of the 5776 community-dwelling older adults >65years who had data on baseline systolic and diastolic blood pressure (SBP and DBP), 28 had isolated diastolic hypertension (DBP >90mmHg and SBP <140mmHg). From the 5748 without isolated diastolic hypertension, we excluded those with SBP >120mmHg (n=4451), DBP 80-89mmHg (n=20), DBP <60mmHg (n=425), normal BP taking anti-hypertensive medications (n=311), normal BP taking no anti-hypertensive medications but with history of hypertension (n=38), and baseline HF (n=5). The final cohort of 524 participants included 27 with isolated diastolic hypertension. RESULTS: Patients (n=524) had a mean (+/-SD) age of 71 (+/-5) years, 58% were women and 9% African American. There were no significant between-group age or sex differences; 37% of those with isolated diastolic hypertension (versus 7% without) were African American. Incident HF occurred in 19% and 7% of participants with and without isolated diastolic hypertension, respectively (multivariable-adjusted hazard ratio , 4.65; 95% confidence interval , 1.09-19.90; p=0.038). There was a trend toward higher cardiovascular mortality (HR, 4.59; 95% CI, 0.92-23.88; p=0.063).
English
0167-5273
IN PROCESS -- NOT YET INDEXED
MedStar Washington Hospital Center
Medicine/Internal Medicine
Journal Article