TY  - BOOK
AU  - Dooley, Daniel J
AU  - Lam, Phillip H
AU  - Tsimploulis, Apostolos
TI  - Systolic-diastolic hypertension versus isolated systolic hypertension and incident heart failure in older adults: Insights from the Cardiovascular Health Study
SN  - 0167-5273
PY  - 2017///
KW  - *Antihypertensive Agents/tu [Therapeutic Use]
KW  - *Blood Pressure
KW  - *Heart Failure
KW  - *Hypertension
KW  - Aged
KW  - Blood Pressure/de [Drug Effects]
KW  - Blood Pressure/ph [Physiology]
KW  - Cardiovascular Diseases/mo [Mortality]
KW  - Diastole/ph [Physiology]
KW  - Female
KW  - Heart Failure/di [Diagnosis]
KW  - Heart Failure/ep [Epidemiology]
KW  - Heart Failure/et [Etiology]
KW  - Heart Failure/pp [Physiopathology]
KW  - Humans
KW  - Hypertension/di [Diagnosis]
KW  - Hypertension/dt [Drug Therapy]
KW  - Hypertension/pp [Physiopathology]
KW  - Incidence
KW  - Male
KW  - Proportional Hazards Models
KW  - Prospective Studies
KW  - Risk Factors
KW  - Systole/ph [Physiology]
KW  - United States/ep [Epidemiology]
KW  - MedStar Heart & Vascular Institute
KW  - MedStar Washington Hospital Center
KW  - Medicine/Internal Medicine
KW  - Journal Article
N2  - 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)
UR  - https://dx.doi.org/10.1016/j.ijcard.2017.02.139
ER  -