Systolic-diastolic hypertension versus isolated systolic hypertension and incident heart failure in older adults: Insights from the Cardiovascular Health Study.

MedStar author(s):
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
Name of journal: International journal of cardiologyAbstract: 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).All authors: Ahmed A, Alagiakrishnan K, Allman RM, Anker MS, Anker SD, Aronow WS, Banach M, Blackman MR, Deedwania P, Dooley DJ, Faselis C, Fletcher RD, Fonarow GC, Lam PH, Morgan CJ, Papademetriou V, Sheriff HM, Tsimploulis A, Valentova M, White MFiscal year: FY2017Digital Object Identifier: Date added to catalog: 2017-05-06
Holdings
Item type Current library Collection Call number Status Date due Barcode
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).

English

Powered by Koha