Effect of Blood Pressure on Cardiovascular Diseases at 10-Year Follow-Up

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The American College of Cardiology/American Heart Association (ACC/AHA) recently published a Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults. However, the data in other ethnic groups are not well known. We evaluated the prevalence and associated cardiovascular prognosis of Korean subjects with newly reclassified hypertension based on the 2017ACC/AHA guideline. We analyzed data from the Korean Health and Genome Study (n = 10,038). Supine blood pressure (BP) was measured thrice following a standardized protocol and averaged. There was a significant linear relation between BP profiles and cardiovascular disease (CVD)/mortality. Hazard ratio for CVD increased above a systolic BP of 120mm Hg. Systolic BP ≥130mm Hg was significantly associated with increased risk of CVD, coronary heart disease, stroke, CVD death, and total deaths. There was a similar significant linear relation with diastolic BP categories between CVD risk and death. BP is associated with an increased risk of CVD or all-cause mortalities. Moreover, the new BP categories of the 2017ACC/AHA guideline could be applicable for predicting CVD and death in Korean population.

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Methods

The design and baseline characteristics of the Ansung-Ansan community-based cohort study were published elsewhere.12 Briefly, the study is an ongoing prospective, biennial follow-up study that is part of the Korean Health and Genome Study (KHGS). It is a community-based epidemiological survey to investigate trends in diabetes mellitus and associated risk factors. The baseline examinations were carried out from 2001 to 2002, and biennial follow-up examinations were continued through 2012. As

Results

We categorized subjects into systolic and diastolic BP categories (normal, elevated, and hypertension group) according to AHA guideline definition.9 The prevalence of hypertension was 32.8% according to the 2017ACC/AHA guideline in this study. The clinical and biochemical characteristics of subjects according to systolic BP categories are shown in Table1. Positive relations were observed between the systolic BP categories and age, being male, body mass index, waist circumference, fasting serum

Discussion

The present study documents the potential clinical implications of the 2017ACC/AHA hypertension guideline for Korean adult subjects. Systolic BP ≥130mm Hg was significantly associated with increased risk of CVD, CHD, and total deaths. Patients classified as having hypertension by new guideline-faced risks of composite CVD and death over an average 9.8years of follow-up.

The risk of CVD increases progressively as BP levels increase, with no apparent threshold beyond which one could safely

Disclosures

All authors have no conflict of interest to disclose.

Acknowledgment

We are grateful to Bong Deok Kim and Hyun Kyu Kim, staff members at the Center for Clinical Epidemiology at the Ajou University School of Medicine, for their work in managing the Korean Health and Genome Study.

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  • This work was supported by the research fund of Dong-A University, Busan, Republic of Korea. The funding source had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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    These authors contributed equally to this work.

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