Clinical Benefit of Treatment of Stage-1, Low-Risk Hypertension: Korean National Health Insurance Database Analysis
- 주제(키워드) blood pressure , hypertension , mortality , myocardial infarction , stroke
- 주제(기타) Peripheral Vascular Disease
- 설명문(일반) [Lee, Chan Joo] Severance Hosp, Dept Hlth Promot, Seoul, South Korea; [Ryu, Jiin; Hwang, Jinseub] Daegu Univ, Dept Stat & Comp Sci, Gyeongbuk, South Korea; [Kim, Hyeon-Chang] Yonsei Univ, Dept Prevent Med, Coll Med, Seoul, South Korea; [Ryu, Dong-Ryeol] Ewha Womans Univ, Sch Med, Div Nephrol, Dept Internal Med, Seoul, South Korea; [Pyun, Wook Bum] Ewha Womans Univ, Sch Med, Dept Internal Med, Ctr Cardiovasc, Seoul, South Korea; [Ihm, Sang-Hyun] Catholic Univ Korea, Div Cardiol, Dept Internal Med, Coll Med, Seoul, South Korea; [Kim, Yong-Jin] Seoul Natl Univ, Div Cardiol, Coll Med, Seoul, South Korea; [Shin, Jin-Ho] Hanyang Univ, Div Cardiol, Dept Internal Med, Coll Med, Seoul, South Korea; [Kang, Hyoung-Soo; Park, Jong-Heon] Natl Hlth Insurance Serv, Dept Big Data Steering, Wonju, Gangwon, South Korea; [Park, Sungha] Yonsei Univ, Coll Med, Severance Cardiovasc Hosp, Div Cardiol,Cardiovasc Res Inst, Seoul, South Korea
- 등재 SCIE, SCOPUS
- 발행기관 LIPPINCOTT WILLIAMS & WILKINS
- 발행년도 2018
- URI http://www.dcollection.net/handler/ewha/000000156090
- 본문언어 영어
- Published As http://dx.doi.org/10.1161/HYPERTENSIONAHA.118.11787
초록/요약
Evidence about the benefits of treating uncomplicated, low-risk, stage-1 hypertension is lacking. The study aimed to investigate the association between mean blood pressure (BP) and clinical outcomes, and to determine optimal BPs in treated, low-risk, stage-1 hypertension. From the National Health Insurance Service Health Examination Database, patients with stage-1 hypertension between 2005 and 2006 were selected. They had a systolic BP of 140 to 159 mmHg or diastolic BP of 90 to 99 mmHg. Patients were grouped as controlled (mean BP <140/90 mmHg; n=99301) and uncontrolled (mean BP 140/90 mmHg; n=49460) according to their mean BP recorded during the follow-up health examination. All-cause mortality and cardiovascular outcomes were examined. Mean BPs in the controlled and uncontrolled groups were 131.1/80.9 and 144.6/86.8 mmHg, respectively. Controlled BP was associated with significantly lower risks of all-cause mortality, all stroke, hemorrhagic stroke, ischemic stroke, and end-stage renal disease. Subgroup analysis demonstrated benefits of controlled BP in hypertensive patients aged <50 years for all-cause mortality, all stroke, hemorrhagic stroke, ischemic stroke, and end-stage renal disease, with no significant interaction according to age. The BP associated with the lowest risk of all-cause mortality was 120 to <130 mmHg (systolic BP) and 70 to <80 mmHg (diastolic BP). There was an increased risk of myocardial infarction in patients with mean systolic BP <120 mmHg and diastolic BP <80 mmHg. BP <140/90 mmHg was associated with a significant reduction in the risk of mortality, stroke, and end-stage renal disease, with the lowest mortality risk at BP ranges of 120 to <130 and 70 to <80 mmHg.
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