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Effects of Prehypertension and Hypertension Subtype on Cardiovascular Disease in the Asia-Pacific Region.
MedLine Citation:
PMID:  22547441     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure defined blood pressure (BP) levels of 120 to 139/80 to 89 mm Hg as prehypertension and those of ≥140/90 mm Hg as hypertension. Hypertension can be divided into 3 categories, isolated diastolic (IDH; systolic BP <140 mm Hg and diastolic BP ≥90 mm Hg), isolated systolic (systolic BP ≥140 mm Hg and diastolic BP <90 mm Hg), and systolic-diastolic hypertension (systolic BP ≥140 mm Hg and diastolic BP ≥90 mm Hg). Although there is clear evidence that isolated systolic hypertension and systolic-diastolic hypertension increase the risks of future vascular events, there remains uncertainty about the effects of IDH. The objective was to determine the effects of prehypertension and hypertension subtypes (IDH, isolated systolic hypertension, and systolic-diastolic hypertension) on the risks of cardiovascular disease (CVD) in the Asia-Pacific Region. The Asia Pacific Cohort Studies Collaboration is an individual participant data overview of cohort studies in the region. This analysis included a total of 346 570 participants from 36 cohort studies. Outcomes were fatal and nonfatal CVD. The relationship between BP categories and CVD was explored using a Cox proportional hazards model adjusted for age, cholesterol, and smoking and stratified by sex and study. Compared with normal BP (<120/80 mm Hg), hazard ratios (95% CIs) for CVD were 1.41 (1.31-1.53) for prehypertension, 1.81 (1.61-2.04) for IDH, 2.18 (2.00-2.37) for isolated systolic hypertension, and 3.42 (3.17-3.70) for systolic-diastolic hypertension. Separately significant effects of prehypertension and hypertension subtypes were also observed for coronary heart disease, ischemic stroke, and hemorrhagic stroke. In the Asia-Pacific region, prehypertension and all hypertension subtypes, including IDH, thus clearly predicted increased risks of CVD.
Authors:
Hisatomi Arima; Yoshitaka Murakami; Tai Hing Lam; Hyeon Chang Kim; Hirotsugu Ueshima; Jean Woo; Il Suh; Xianghua Fang; Mark Woodward;
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-4-30
Journal Detail:
Title:  Hypertension     Volume:  -     ISSN:  1524-4563     ISO Abbreviation:  -     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-5-1     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7906255     Medline TA:  Hypertension     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
George Institute for Global Health, University of Sydney, Sydney, New South Wales, Australia; School of Public Health/Department of Community Medicine, University of Hong Kong, Hong Kong, China; Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Health Science, Shiga University of Medical Science, Shiga, Japan; Division of Geriatrics, Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong, China; Department of Epidemiology and Social Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China; Department of Epidemiology, Johns Hopkins University, Baltimore, MD.
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