Systolic-diastolic hypertension versus isolated systolic hypertension and incident heart failure in older adults: Insights from the Cardiovascular Health Study.
Citation: International Journal of Cardiology. 235:11-16, 2017 May 15PMID: 28291625Institution: MedStar Heart & Vascular Institute | MedStar Washington Hospital CenterDepartment: Medicine/Internal MedicineForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Antihypertensive Agents/tu [Therapeutic Use] | *Blood Pressure | *Heart Failure | *Hypertension | Aged | Blood Pressure/de [Drug Effects] | Blood Pressure/ph [Physiology] | Cardiovascular Diseases/mo [Mortality] | Diastole/ph [Physiology] | Female | Heart Failure/di [Diagnosis] | Heart Failure/ep [Epidemiology] | Heart Failure/et [Etiology] | Heart Failure/pp [Physiopathology] | Humans | Hypertension/di [Diagnosis] | Hypertension/dt [Drug Therapy] | Hypertension/pp [Physiopathology] | Incidence | Male | Proportional Hazards Models | Prospective Studies | Risk Factors | Systole/ph [Physiology] | United States/ep [Epidemiology]Year: 2017ISSN:- 0167-5273
Item type | Current library | Collection | Call number | Status | Date due | Barcode |
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Journal Article | MedStar Authors Catalog | Article | 28291625 | Available | 28291625 |
BACKGROUND: Isolated systolic hypertension (ISH) is common in older adults and is a risk factor for incident heart failure (HF). We examined the association of systolic-diastolic hypertension (SDH) with incident HF and other outcomes in older adults.
CONCLUSION: Among older adults with hypertension, both SDH and ISH have similar associations with incident HF and cardiovascular mortality.
Copyright Published by Elsevier B.V.
METHODS: In the Cardiovascular Health Study (CHS), 5776 community-dwelling adults>65years had data on baseline systolic and diastolic blood pressure (SBP and DBP). We excluded those with DBP<60mmHg (n=821), DBP>90 and SBP<140mmHg (n=28), normal BP, taking anti-hypertensive drugs (n=1138), normal BP, not taking anti-hypertensive drugs, history of hypertension (n=193), and baseline HF (n=101). Of the remaining 3495, 1838 had ISH (SBP>140 and DBP<90mmHg) and 240 had SDH (SBP>140 and DBP>90mmHg). The main outcome was centrally-adjudicated incident HF over 13years of follow-up.
RESULTS: Participants had a mean (+/-SD) age of 73 (+/-6)years, 57% were women, and 16% African American. Incident HF occurred in 25%, 22% and 11% of participants with ISH, SDH and no hypertension, respectively. Compared to no hypertension, multivariable-adjusted hazard ratios (HR) and 95% confidence intervals (CI) for incident HF associated with ISH and SDH were 1.86 (1.51-2.30) and 1.73 (1.23-2.42), respectively. Cardiovascular mortality occurred in 22%, 24% and 9% of those with ISH, SDH and no hypertension, respectively with respective multivariable-adjusted HRs (95% CIs) of 1.88 (1.49-2.37) and 2.30 (1.64-3.24).
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