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The significance of low DBP in US adults with isolated systolic hypertension.
MedLine Citation:
PMID:  21478753     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVES: To determine the features of isolated systolic hypertension (ISH), the most common hypertensive subtype in persons at least age 50, associated with greater cardiovascular disease (CVD) risk when accompanied by low diastolic blood pressure (DBP). DESIGN: Data were obtained from adult hypertensives at least age 18 in the National Health Nutrition Examination Survey (NHANES) 1999-2006 (n = 19 808, projected to 199.3 million). METHOD: ISH were categorized by low DBP (<70 mmHg) vs. higher DBP (≥70-89 mmHg), treatment status, age, sex, ethnicity, cardiometabolic risk factors, and comorbidities. RESULTS: A 58.6% of all untreated US hypertensives had ISH (mean blood pressure 154.3/73.8 mmHg). Untreated and treated persons with ISH and DBP less than 70 mmHg represented 30 and 35%, respectively, of the ISH population and had almost twice the prevalence of diabetes and CVD, but a lower prevalence of the metabolic syndrome (P < 0.05 to P < 0.01). There was a three-fold greater prevalence of CVD from the highest to the lowest DBP strata in untreated ISH (P < 0.01). Logistic regression showed that age, female sex, and diabetes, but not treatment status, were independently associated with lower DBP (all P < 0.01). Of those persons with ISH and DBP less than 70 mmHg, 45% remain untreated. CONCLUSION: Older persons with untreated ISH and DBP less than 70 mmHg, comprising almost one-third of the untreated ISH population, had greater prevalence of diabetes and CVD than persons with ISH in association with DBP 70-89 mmHg. Intensified efforts to identify and adequately treat these individuals are needed to reduce their associated CVD risk.
Authors:
Stanley S Franklin; Vincent H Chow; Alessandro D Mori; Nathan D Wong
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-4-8
Journal Detail:
Title:  Journal of hypertension     Volume:  -     ISSN:  1473-5598     ISO Abbreviation:  -     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-4-11     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8306882     Medline TA:  J Hypertens     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
aThe Heart Disease Prevention Program, Division of Cardiology, University of California, Irvine, California, USA bForest Research Laboratories, East Hanover, New Jersey, USA.
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