Cardiovascular events according to blood pressure thresholds recommended by ACC/AHA
Aim The latest guidelines from ACC/AHA define hypertension at systolic blood pressure (SBP) 130-139 mmHg or diastolic blood pressure (DBP) 80-89 mmHg in contrast to guidelines from ESC/ESH defining hypertension at SBP ≥ 140 mmHg or DBP ≥ 90 mmHg. The aim was to determine whether the ACC/AHA definiti...
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Taylor & Francis Group
2024-12-01
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| Series: | Blood Pressure |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/08037051.2024.2380346 |
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| author | Gowsini Joseph Vi Thanh Pham Per Kragh Andersen Jacob Louis Marott Rasmus Møgelvang Tor Biering-Sørensen Peter Søgaard Gitte Nielsen Eva Prescott Gorm Boje Jensen Niels Eske Bruun Christian Torp-Pedersen |
| author_facet | Gowsini Joseph Vi Thanh Pham Per Kragh Andersen Jacob Louis Marott Rasmus Møgelvang Tor Biering-Sørensen Peter Søgaard Gitte Nielsen Eva Prescott Gorm Boje Jensen Niels Eske Bruun Christian Torp-Pedersen |
| author_sort | Gowsini Joseph |
| collection | DOAJ |
| description | Aim The latest guidelines from ACC/AHA define hypertension at systolic blood pressure (SBP) 130-139 mmHg or diastolic blood pressure (DBP) 80-89 mmHg in contrast to guidelines from ESC/ESH defining hypertension at SBP ≥ 140 mmHg or DBP ≥ 90 mmHg. The aim was to determine whether the ACC/AHA definition of hypertension identifies persons at elevated risk for future cardiovascular outcome.Methods In a Danish prospective cardiovascular study, 19,721 white men and women aged 20-98 years were examined up to five occasions between 1976 and 2015. The population was followed until December 2018. The ACC/AHA definition of the BP levels were applied: Normal: SBP <120 mmHg and DBP <80 mmHg, Elevated: SBP 120-129 mmHg and DBP <80 mmHg, Stage 1: SBP 130-139 mmHg or DBP 80-89 mmHg, Stage 2: SBP ≥140 mmHg or DBP ≥90 mmHg. Absolute 10-year risk was calculated taking repeated examinations, covariates, and competing risk into account.Results For all outcomes, the 10-year risk in stage 1 hypertension did not differ significantly from risk in subjects with normal BP: The 10-year risk of cardiovascular events in stage 1 hypertension was 14.1% [95% CI 13.2;15.0] and did not differ significantly from the risk in normal BP at 12.8% [95% CI 11.1;14.5] (p = 0.19). The risk was highest in stage 2 hypertension 19.4% [95% CI 18.9;20.0] and differed significantly from normal BP, elevated BP, and stage 1 hypertension (p < 0.001). The 10-year risk of cardiovascular death was 6.6% [95% CI 5.9;7.4] in stage 1 hypertension and did not differ significantly from the risk in normal BP at 5.7% [95% CI 4.1;7.3] (p = 0.33).Conclusions Stage 1 hypertension as defined by the ACC/AHA guidelines has the same risk for future cardiovascular events as normal BP. In contrast, the definition of hypertension as suggested by ESC/ESH identifies patients with elevated risk of cardiovascular events. |
| format | Article |
| id | doaj-art-ad895553f3764943bf7a143b31a34f3f |
| institution | Kabale University |
| issn | 0803-7051 1651-1999 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Blood Pressure |
| spelling | doaj-art-ad895553f3764943bf7a143b31a34f3f2024-12-02T01:18:47ZengTaylor & Francis GroupBlood Pressure0803-70511651-19992024-12-0133110.1080/08037051.2024.2380346Cardiovascular events according to blood pressure thresholds recommended by ACC/AHAGowsini Joseph0Vi Thanh Pham1Per Kragh Andersen2Jacob Louis Marott3Rasmus Møgelvang4Tor Biering-Sørensen5Peter Søgaard6Gitte Nielsen7Eva Prescott8Gorm Boje Jensen9Niels Eske Bruun10Christian Torp-Pedersen11Department of Cardiology, Zealand University Hospital, Roskilde, DenmarkSection of Biostatistics, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, DenmarkSection of Biostatistics, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, DenmarkThe Copenhagen City Heart Study, Frederiksberg-Bispebjerg Hospitals, Frederiksberg, DenmarkThe Copenhagen City Heart Study, Frederiksberg-Bispebjerg Hospitals, Frederiksberg, DenmarkThe Copenhagen City Heart Study, Frederiksberg-Bispebjerg Hospitals, Frederiksberg, DenmarkDepartment of Clinical Medicine, Aalborg University, Aalborg, DenmarkDepartment of Cardiology, North Denmark Regional Hospital, Hjørring, DenmarkThe Copenhagen City Heart Study, Frederiksberg-Bispebjerg Hospitals, Frederiksberg, DenmarkThe Copenhagen City Heart Study, Frederiksberg-Bispebjerg Hospitals, Frederiksberg, DenmarkDepartment of Cardiology, Zealand University Hospital, Roskilde, DenmarkDepartment of Cardiology, Nordsjaellands Hospital, Hillerød, DenmarkAim The latest guidelines from ACC/AHA define hypertension at systolic blood pressure (SBP) 130-139 mmHg or diastolic blood pressure (DBP) 80-89 mmHg in contrast to guidelines from ESC/ESH defining hypertension at SBP ≥ 140 mmHg or DBP ≥ 90 mmHg. The aim was to determine whether the ACC/AHA definition of hypertension identifies persons at elevated risk for future cardiovascular outcome.Methods In a Danish prospective cardiovascular study, 19,721 white men and women aged 20-98 years were examined up to five occasions between 1976 and 2015. The population was followed until December 2018. The ACC/AHA definition of the BP levels were applied: Normal: SBP <120 mmHg and DBP <80 mmHg, Elevated: SBP 120-129 mmHg and DBP <80 mmHg, Stage 1: SBP 130-139 mmHg or DBP 80-89 mmHg, Stage 2: SBP ≥140 mmHg or DBP ≥90 mmHg. Absolute 10-year risk was calculated taking repeated examinations, covariates, and competing risk into account.Results For all outcomes, the 10-year risk in stage 1 hypertension did not differ significantly from risk in subjects with normal BP: The 10-year risk of cardiovascular events in stage 1 hypertension was 14.1% [95% CI 13.2;15.0] and did not differ significantly from the risk in normal BP at 12.8% [95% CI 11.1;14.5] (p = 0.19). The risk was highest in stage 2 hypertension 19.4% [95% CI 18.9;20.0] and differed significantly from normal BP, elevated BP, and stage 1 hypertension (p < 0.001). The 10-year risk of cardiovascular death was 6.6% [95% CI 5.9;7.4] in stage 1 hypertension and did not differ significantly from the risk in normal BP at 5.7% [95% CI 4.1;7.3] (p = 0.33).Conclusions Stage 1 hypertension as defined by the ACC/AHA guidelines has the same risk for future cardiovascular events as normal BP. In contrast, the definition of hypertension as suggested by ESC/ESH identifies patients with elevated risk of cardiovascular events.https://www.tandfonline.com/doi/10.1080/08037051.2024.2380346hypertensionACC/AHA guidelinesmortalitycardiovascular outcomeblood pressure thresholds |
| spellingShingle | Gowsini Joseph Vi Thanh Pham Per Kragh Andersen Jacob Louis Marott Rasmus Møgelvang Tor Biering-Sørensen Peter Søgaard Gitte Nielsen Eva Prescott Gorm Boje Jensen Niels Eske Bruun Christian Torp-Pedersen Cardiovascular events according to blood pressure thresholds recommended by ACC/AHA Blood Pressure hypertension ACC/AHA guidelines mortality cardiovascular outcome blood pressure thresholds |
| title | Cardiovascular events according to blood pressure thresholds recommended by ACC/AHA |
| title_full | Cardiovascular events according to blood pressure thresholds recommended by ACC/AHA |
| title_fullStr | Cardiovascular events according to blood pressure thresholds recommended by ACC/AHA |
| title_full_unstemmed | Cardiovascular events according to blood pressure thresholds recommended by ACC/AHA |
| title_short | Cardiovascular events according to blood pressure thresholds recommended by ACC/AHA |
| title_sort | cardiovascular events according to blood pressure thresholds recommended by acc aha |
| topic | hypertension ACC/AHA guidelines mortality cardiovascular outcome blood pressure thresholds |
| url | https://www.tandfonline.com/doi/10.1080/08037051.2024.2380346 |
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