Study: do not forget the other partner number

One study has shown that both systolic and diastolic blood pressure play a role in cardiovascular health.

Above the 75th percentile, systolic blood pressure (HR 1.40, 95% CI: 1.38-1.43) and diastolic blood pressure (HR 1.22, 95% CI, 1.20-1, 24) predicted poor results regardless of demographics and coexisting conditions, reported researchers led by Alexander Flint, MD, PhD, of Kaiser Permanente Northern California in Oakland.

The hypertension thresholds, new and old, also confirmed the badociation between high blood pressure and a higher risk of combined risk of myocardial infarction, ischemic stroke and stroke. Haemorrhagic stroke in Cox multi-variable regression badyzes:

• Systolic Hypertension (≥ 140 mm Hg): HR 1.18 per Unit Increased Standardized Z Score (95% CI: 1.17-1.18)
• Systolic Hypertension (≥ 130 mm Hg): HR 1.18 (95% CI 1.17-1.19)
• Diastolic hypertension (≥ 90 mm Hg): HR 1.06 (95% CI 1.06-1.07)
• Diastolic hypertension (≥ 80 mm Hg): HR 1.08 (95% CI 1.06-1.09)

"Although the rise in systolic blood pressure had a greater effect on the results, systolic and diastolic hypertension independently influenced the risk of adverse cardiovascular events, regardless of the definition of hypertension (≥140 / 90 mmHg or ≥130 / 80 mmHg), "the authors concluded in the New England Journal of Medicine.

Therefore, "diastolic blood pressure should not be ignored," they said, adding that their findings supported recent changes in the guidelines in order to move to the goal of lower blood pressure.

A J-curve for diastolic blood pressure was observed in the badysis, so that there was a higher risk of adverse effects at high and low values.

"We found that curve J was explained at least in part by the relationship between age and other covariates, and we also found that systolic hypertension had a stronger effect in the group. participants with lower diastolic blood pressure, which had previously been reported to explain the J-curve, reported the investigators.

For the study, Flint Group consulted the electronic medical records of more than 1.3 million adults in the Kaiser Permanente Northern California health system who had readings of outpatient blood pressure.

There were over 36 million blood pressure measurements available; all had been taken by automated blood pressure cuff.

Adverse events were noted over an 8-year observation period. During this period, the expected risks were as follows for the weighted average blood pressure:

• Systolic blood pressure of about 160 mmHg: 4.8%
• Systolic blood pressure approximately 136 mm Hg: 1.9%
• Diastolic blood pressure about 96 mmHg: 3.6%
• Diastolic blood pressure of about 81 mmHg: 1.9%

The retrospective study did not include deaths in the primary endpoint or missing cholesterol data.

However, the study remains important given the importance of systolic and diastolic blood pressure in future cardiovascular risk, according to Monika Sanghavi, MD, of Philadelphia's Penn Heart and Vascular Center, which was not part of the Flint group. .

"While the focus is on the diagnosis of arterial hypertension in the clinic rather than outpatient, there is confusion about the diagnostic thresholds.This study confirms the idea that a lower threshold of> 130/80 mmHg to diagnose hypertension may be appropriate because it is also a powerful predictor of adverse cardiovascular events ", MedPage today.

2019-07-18T12: 30: 36-0400