JNC 7 category and risk of cardiovascular death in men: are there differences by age?

Area of Science:

• Cardiology
• Public Health
• Epidemiology

Background:

• The Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7) established guidelines for blood pressure classification.
• Understanding the cardiovascular disease (CVD) death risk associated with JNC 7 categories, particularly prehypertension, is crucial for public health.
• Investigating potential age-related differences in these associations is important for targeted interventions.

Purpose of the Study:

• To evaluate the JNC 7 blood pressure classification scheme's association with cardiovascular disease death risk.
• To determine if the association between JNC 7 blood pressure categories and CVD death varies by age.

Main Methods:

• A prospective cohort study involving 53,163 apparently healthy participants aged 39-85 years, followed for 5.7 years.
• Calculation of relative risks and 95% confidence intervals for CVD death, adjusted for major risk factors.
• Stratification of analyses by age groups (39-49, 50-59, 60-69, 70-84 years) with heterogeneity testing.

Main Results:

• Compared to normal blood pressure, hypertension was associated with a multivariate-adjusted relative risk of 1.54 (95% CI, 1.08-2.19) for CVD death.
• Prehypertension was not associated with a significantly increased risk of CVD death (multivariate-adjusted RR, 1.02; 95% CI, 0.73-1.42).
• No significant age-related effect modification was observed (P-interaction = 0.22).

Conclusions:

• The JNC 7 classification of prehypertension was not linked to a significantly elevated risk of cardiovascular disease death in this cohort.
• The study found no significant modification of the JNC 7 blood pressure category associations with CVD death by age.
• Findings suggest that current JNC 7 guidelines may need re-evaluation regarding the risk stratification of prehypertension and its impact across different age groups.