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Office Blood Pressure Range and Cardiovascular Events in Patients With Hypertension: A Nationwide Cohort Study in South Korea

  • 주제(키워드) blood pressure , cardiovascular events , hypertension
  • 주제(기타) Cardiac & Cardiovascular Systems
  • 설명문(일반) [Sung, Ki-Chul] Sungkyunkwan Univ, Kangbuk Samsung Hosp, Dept Internal Med, Div Cardiol,Sch Med, 29 Saemunan Ro, Seoul 03181, South Korea; [Cho, In Jeong; Pyun, Wook Bum] Ewha Womans Univ, Dept Internal Med, Div Cardiol, Med Ctr, 260 Gonghangdae Ro, Seoul 07804, South Korea; [Kwon, Chang Hee] Konkuk Univ, Sch Med, Dept Internal Med, Div Cardiol,Med Ctr, Seoul, South Korea; [Kim, Woohyeun; Shin, Jeong-Hun; Shin, Jinho] Hanyang Univ, Dept Internal Med, Div Cardiol, Coll Med, Seoul, South Korea; [Lee, Chan Joo; Kim, Hyeon-Chang; Cho, Iksung; Park, Sungha; Kang, Seok-Min] Yonsei Univ, Div Cardiol, Severance Cardiovasc Hosp, Coll Med, Seoul, South Korea; [Lee, Chan Joo; Kim, Hyeon-Chang; Cho, Iksung; Park, Sungha; Kang, Seok-Min] Yonsei Univ, Cardiovasc Res Inst, Coll Med, Seoul, South Korea; [Kang, Si-Hyuck] Seoul Natl Univ, Bundang Hosp, Cardiovasc Ctr, Coll Med, Seongnam, South Korea; [Jung, Mi-Hyang] Hallym Univ, Dongtan Sacred Heart Hosp, Cardiovasc Ctr, Coll Med, Hwaseong, South Korea; [Kim, Dae-Hee] Univ Ulsan, Asan Med Ctr, Div Cardiol, Coll Med, Seoul, South Korea; [Lee, Ju-Hee; Cho, Myeong-Chan] Chungbuk Natl Univ, Chungbuk Natl Univ Hosp, Dept Internal Med, Div Cardiol,Coll Med, Cheongju, South Korea; [Kim, Hack Lyoung] Seoul Natl Univ, Boramae Med Ctr, Dept Internal Med, Coll Med, Seoul, South Korea; [Kim, Hyue Mee] Chung Ang Univ, Chung Ang Univ Hosp, Dept Internal Med, Div Cardiol, Seoul, South Korea; [Kang, Dae Ryong] Yonsei Univ, Wonju Coll Med, Dept Precis Med, Wonju, South Korea; [Lee, Hae-Young] Seoul Natl Univ Hosp, Div Cardiol, Dept Internal Med, Seoul, South Korea; [Chung, Wook-Jin] Gachon Univ, Gil Hosp, Dept Internal Med, Div Cardiol, Incheon, South Korea; [Ihm, Sang-Hyun] Catholic Univ Korea, Dept Internal Med, Div Cardiol, Bucheon St Marys Hosp, Seoul, South Korea; [Kim, Kwang Il] Seoul Natl Univ, Coll Med, Dept Internal Med, Bundang Hosp, Seongnam, South Korea; [Cho, Eun Joo] Catholic Univ Korea, Dept Internal Med, Div Cardiol, Yeouido St Marys Hosp, Seoul, South Korea; [Sohn, Il-Suk] Kyung Hee Univ Gangdong, Div Cardiol, Dept Internal Med, Seoul, South Korea; [Ryu, Sung Kee] Eulji Med, Dept Internal Med, Div Cardiol, Sch Med, Seoul, South Korea; [Kim, Ju Han] Chonnam Natl Univ Hosp, Dept Internal Med, Div Cardiol, Gwangju, South Korea; [Lee, Jun Hyeok] Yonsei Univ, Wonju Coll Med, Dept Biostat, Wonju, South Korea; [Kim, Jang-Young] Yonsei Univ, Dept Cardiol, Wonju Coll Med, Wonju, South Korea
  • 등재 SCIE, SCOPUS
  • 발행기관 WILEY
  • 발행년도 2021
  • 총서유형 Journal
  • URI http://www.dcollection.net/handler/ewha/000000183423
  • 본문언어 영어
  • Published As http://dx.doi.org/10.1161/JAHA.120.017890

초록/요약

Background It is unclear what office blood pressure (BP) is the optimal treatment target range in patients with hypertension. Methods and Results Using the Korean National Health Insurance Service database, we extracted the data on 479 359 patients with hypertension with available BP measurements and no history of cardiovascular events from 2002 to 2011. The study end point was major cardiovascular events (MACE), a composite of cardiovascular death, myocardial infarction, or stroke. This cohort study evaluated the association of BP levels (<120/<70, 120-129/70-79, 130-139/80-89, 140-149/90-99, and >= 150/>= 100 mm Hg) with MACE. During a median follow-up of 9 years, 55 401 MACE were documented in our cohort. The risk of MACE was the lowest (adjusted hazard ratio [HR], 0.79; 95% CI, 0.76-0.84) at BP level of <120/<70 mm Hg, and was the highest (HR, 1.32; 95% CI, 1.29-1.36) at >= 150/>= 100 mm Hg in comparison with 130 to 139/80 to 89 mm Hg. These results were consistent in all age groups and both sexes. Among patients treated with antihypertensive medication (n=237 592, 49.5%), in comparison with a BP level of 130 to 139/80 to 89 mm Hg, the risk of MACE was significantly higher in patients with elevated BP (>= 140/>= 90 mm Hg), but not significantly lower in patients with BP of Conclusions BP level is significantly correlated with the risk of MACE in all Korean patients with hypertension. However, there were no additional benefits for MACE amongst those treated for hypertension with BP <120/70 mm Hg.

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