Document Detail


Uncontrolled hypertension and increased risk for incident heart failure in older adults with hypertension: findings from a propensity-matched prospective population study.
MedLine Citation:
PMID:  20374948     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Hypertension is a risk factor for incident heart failure (HF). However, the effect of uncontrolled blood pressure (BP) on incident HF in older adults with hypertension has not been prospectively examined in propensity-matched studies. Of the 5795 Cardiovascular Health Study participants, > or =65 years, 2562 with self-reported physician-diagnosed hypertension had no baseline HF. Of these, 1391 had uncontrolled hypertension, defined as systolic BP (SBP) > or =140 (n = 1373) or diastolic BP > or =90 mm Hg (n = 18). Propensity scores for uncontrolled hypertension, calculated for each participant, were used to assemble a cohort of 1021 pairs of participants with controlled and uncontrolled hypertension who were balanced on 31 baseline characteristics. Centrally adjudicated incident HF developed in 23% and 26% of participants with controlled and uncontrolled hypertension respectively during 13 years of follow-up (matched hazard ratio [HR] when uncontrolled hypertension was compared with controlled hypertension, 1.39; 95% confidence interval [CI], 1.12 to 1.73; P = .003). HRs (95% CI) for incident HF for those with (n = 503) and without (n = 1539) chronic kidney disease (CKD) were 1.73 (95% CI, 1.26 to 2.38; P = .001) and 1.08 (95% CI, 0.87 to 1.34; P = .486) respectively (P for interaction, .012). Compared with participants with controlled hypertension, HRs for incident HF associated with SBP 140 to 159 and > or =160 mm Hg were 1.06 (95% CI, 0.86 to 1.31; P = .572) and 1.58 (95% CI, 1.27 to 1.96; P < .0001), respectively. In community-dwelling older adults with hypertension, those with uncontrolled (versus controlled) BP have increased risk of new-onset HF, which is more pronounced in those with SBP > or =160 mm Hg and with CKD.
Authors:
Anand S Iyer; Mustafa I Ahmed; Gerasimos S Filippatos; O James Ekundayo; Inmaculada B Aban; Thomas E Love; Navin C Nanda; George L Bakris; Gregg C Fonarow; Wilbert S Aronow; Ali Ahmed
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Journal of the American Society of Hypertension : JASH     Volume:  4     ISSN:  1933-1711     ISO Abbreviation:  J Am Soc Hypertens     Publication Date:    2010 Jan-Feb
Date Detail:
Created Date:  2010-04-08     Completed Date:  2010-06-10     Revised Date:  2011-07-19    
Medline Journal Info:
Nlm Unique ID:  101312518     Medline TA:  J Am Soc Hypertens     Country:  United States    
Other Details:
Languages:  eng     Pagination:  22-31     Citation Subset:  IM    
Copyright Information:
Published by Elsevier Inc.
Affiliation:
University of Alabama at Birmingham, Birmingham, AL, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Antihypertensive Agents / therapeutic use
Chronic Disease
Female
Follow-Up Studies
Heart Failure / epidemiology*
Humans
Hypertension / epidemiology*,  therapy*
Incidence
Kidney Diseases / epidemiology
Male
Matched-Pair Analysis
Prospective Studies
Risk
Grant Support
ID/Acronym/Agency:
R01 HL085561-04/HL/NHLBI NIH HHS; R01 HL097047-01/HL/NHLBI NIH HHS; R01 HL097047-02/HL/NHLBI NIH HHS; R01-HL097047/HL/NHLBI NIH HHS; R01HL085561/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Antihypertensive Agents
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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