Blood Pressure Change from Normal to 2017 ACC/AHA Defined Stage 1 Hypertension and Cardiovascular Risk

Area of Science:

• Cardiology
• Public Health
• Epidemiology

Background:

• The 2017 ACC/AHA hypertension guidelines redefined stage 1 hypertension, necessitating investigation into its clinical significance.
• Understanding the impact of blood pressure (BP) elevation from normal to stage 1 hypertension is crucial for cardiovascular disease (CVD) prevention.
• Previous research has not fully elucidated the risks associated with newly elevated BP in Korean adults.

Purpose of the Study:

• To investigate the clinical significance of 2017 ACC/AHA defined stage 1 hypertension in Korean adults.
• To evaluate the association between BP elevation from normal to stage 1 hypertension and the risk of CVD and mortality.
• To assess the risk of CVD associated with elevated BP (120-129/ <80 mmHg) and isolated diastolic hypertension (stage 1).

Main Methods:

• Retrospective analysis of 60,866 Korean adults from a national claims database (2002-2005).
• Participants had normal BP, no prior anti-hypertensive medication, and no history of CVD at baseline.
• Time-dependent Cox proportional hazards models were used to assess the risk of CVD and mortality over a mean 7.8-year follow-up.

Main Results:

• BP elevation to stage 1 hypertension (130-139/80-89 mmHg) was associated with increased risk of CVD (aHR 1.23) and ischemic stroke (aHR 1.32).
• BP elevation to 120-129/ <80 mmHg was linked to a higher CVD risk (aHR 1.26).
• Stage 1 isolated diastolic hypertension ( <130/80-89 mmHg) did not show a significant association with CVD risk (aHR 1.12).

Conclusions:

• Elevating from normal BP to stage 1 hypertension significantly increases the risk of CVD and ischemic stroke in Korean adults.
• Even a moderate BP elevation to 120-129/ <80 mmHg is associated with increased CVD risk.
• The findings underscore the importance of early BP management according to the 2017 ACC/AHA guidelines.