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Cardiovascular or mortality risk of controlled hypertension and importance of physical activity

Sehoon Park1,2, Kyungdo Han3, Soojin Lee4

  • 1Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Korea (the Republic of).

Heart (British Cardiac Society)
|January 6, 2021
PubMed

Insights

Patients with controlled hypertension face increased risks of major adverse cardiac and cerebrovascular events (MACCEs) and death. Physical activity can mitigate these risks, even with achieved blood pressure targets.

Area of Science:

  • Cardiovascular Medicine
  • Public Health
  • Epidemiology

Background:

  • Hypertension management aims to prevent adverse cardiovascular and cerebrovascular events.
  • Residual risks persist even in patients with controlled hypertension.
  • The role of physical activity in mitigating these residual risks requires further investigation.

Purpose of the Study:

  • To investigate the association between controlled hypertension and the risk of major adverse cardiac and cerebrovascular events (MACCEs) and all-cause mortality.
  • To evaluate the potential benefits of physical activity in patients with controlled hypertension.

Main Methods:

  • Observational cohort study utilizing UK Biobank (UKB) and Korean National Health Insurance Service (KNHIS) data.
  • Inclusion criteria: individuals aged 40-69 without prior cardiovascular disease or untreated hypertension.
  • Stratification into normotension, controlled hypertension (BP <140/90 mmHg), and uncontrolled hypertension groups; analysis via Cox regression.

Main Results:

  • Controlled hypertension was associated with significantly higher risks of MACCEs and all-cause mortality compared to normotension in both cohorts.
  • Patients with controlled hypertension who were physically inactive exhibited risks comparable to or exceeding those of physically active patients with uncontrolled hypertension.
  • Adjusted Hazard Ratios (HRs) for MACCEs in controlled hypertension: UKB 1.73, KNHIS 1.46; for all-cause mortality: UKB 1.28, KNHIS 1.29.

Conclusions:

  • Controlled hypertension presents residual risks for adverse cardiovascular and cerebrovascular outcomes.
  • Physical activity is recommended for patients with controlled hypertension, regardless of achieved blood pressure targets.
  • Encouraging physical activity may be a crucial strategy to further reduce adverse outcomes in this population.
Abstract

Keywords:
coronary artery diseaseepidemiologyhypertension

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