| Uncontrolled hypertension and increased risk for incident heart failure in older adults with hypertension: findings from a propensity-matched prospective population study. | |
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MedLine Citation:
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PMID: 20374948 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Journal Article; Research Support, N.I.H., Extramural |
Journal Detail:
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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:
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Created Date: 2010-04-08 Completed Date: 2010-06-10 Revised Date: 2011-07-19 |
Medline Journal Info:
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Nlm Unique ID: 101312518 Medline TA: J Am Soc Hypertens Country: United States |
Other Details:
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Languages: eng Pagination: 22-31 Citation Subset: IM |
Copyright Information:
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Published by Elsevier Inc. |
Affiliation:
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University of Alabama at Birmingham, Birmingham, AL, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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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:
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0/Antihypertensive Agents |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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