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2017 ACC/AHA blood pressure classification and incident peripheral artery disease: The Atherosclerosis Risk in

Yifei Lu1, Shoshana H Ballew1, Hirofumi Tanaka2

  • 1Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA.

European Journal of Preventive Cardiology
|August 1, 2019
PubMed

Insights

Elevated blood pressure, particularly systolic, increases peripheral artery disease (PAD) risk, even at levels below stage 1 hypertension. This highlights the importance of monitoring blood pressure for leg vascular health.

Area of Science:

  • Cardiovascular Medicine
  • Vascular Health
  • Hypertension Research

Background:

  • Peripheral artery disease (PAD) is a significant vascular condition.
  • The 2017 ACC/AHA hypertension guidelines introduced new blood pressure categories.
  • Understanding the link between these categories and PAD risk is crucial for public health.

Purpose of the Study:

  • To assess the association between 2017 ACC/AHA blood pressure categories and incident peripheral artery disease (PAD).
  • To investigate these associations separately in individuals with and without antihypertensive medication.

Main Methods:

  • A cohort of 13,113 middle-aged participants was analyzed.
  • Cox regression models were used to evaluate associations between blood pressure categories (normal, elevated, stage 1, stage 2 hypertension) and incident PAD over a median follow-up of 25.4 years.
  • Analyses were stratified by antihypertensive medication use.

Main Results:

  • In participants not on antihypertensive medication, elevated blood pressure (1.80) and stage 2 hypertension (2.40) were significantly associated with increased PAD risk.
  • Higher systolic blood pressure categories showed a graded association with incident PAD.
  • Participants on antihypertensive medication had a higher PAD risk across all blood pressure categories compared to those not on medication.

Conclusions:

  • Systolic blood pressure, including the 130-139 mmHg category, demonstrated stronger associations with PAD than diastolic blood pressure.
  • Elevated blood pressure poses a risk for PAD comparable to or greater than stage 1 hypertension.
  • These findings have implications for interpreting new blood pressure guidelines regarding leg vascular health.
Abstract

Keywords:
Blood pressurecritical limb ischemiaperipheral artery disease

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