Temporal elevation of blood pressure is associated with increased risk of sudden cardiac arrest
Yun Gi Kim1, Kyongjin Min2, Joo Hee Jeong1
1Division of Cardiology, Department of Internal Medicine, Korea University College of Medicine and Korea University Anam Hospital, 73 Goryeodae-Ro, Seongbuk-Gu, Seoul, 02841, Republic of Korea.
Insights
A rising blood pressure trend significantly increases the risk of sudden cardiac arrest (SCA). Even a small increase in systolic or diastolic blood pressure is linked to higher SCA occurrence, while decreases do not lower risk.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- Hypertension is a recognized risk factor for sudden cardiac arrest (SCA).
- The impact of blood pressure fluctuations over time on SCA risk remains unclear.
- Understanding temporal blood pressure changes is crucial for SCA prevention strategies.
Purpose of the Study:
- To investigate the association between temporal changes in blood pressure and the risk of sudden cardiac arrest (SCA).
- To determine if increasing or decreasing blood pressure trends influence SCA incidence.
Main Methods:
- Analysis of nationwide healthcare insurance data from individuals with health check-ups in 2009 and 2011.
- Evaluation of 8100 SCA events over 17,740,420 person-years of follow-up.
- Multivariate analysis to assess the relationship between blood pressure changes (ΔSBP, ΔDBP) and SCA risk.
Main Results:
- A linear association was found between temporal increases in systolic blood pressure (SBP) and SCA risk.
- Higher SBP increases (e.g., ≥40 mmHg) showed significantly elevated adjusted hazard ratios (HR) for SCA.
- Temporal increases in diastolic blood pressure (DBP) were also significantly associated with increased SCA risk, particularly in the highest ΔDBP group (≥25 mmHg).
Conclusions:
- Temporal increases in blood pressure, both systolic and diastolic, are significantly associated with an increased risk of sudden cardiac arrest (SCA).
- The association between elevated blood pressure and SCA risk was consistent across various subgroups, irrespective of age, sex, diabetes, or baseline blood pressure.
- Preventing blood pressure elevation is likely a key strategy for reducing the incidence of SCA; temporary decreases in blood pressure do not mitigate this risk.
Abstract:
Hypertension is a known risk factor for sudden cardiac arrest (SCA). However, the role of temporal changes in blood pressure on the risk of SCA is not fully understood. This study was conducted to determine whether a temporal increase or decrease in blood pressure is associated with the risk of SCA. This study was based on nationwide healthcare insurance data. Individuals who underwent nationwide health check-ups in 2009 and 2011 were analyzed. A total of 2,801,153 individuals were evaluated for 8100 SCA events during the 17, 740, 420 person-years of follow-up. In a multivariate analysis, there were linear association between the degree of temporal elevation of systolic blood pressure (SBP) and the risk of SCA: (i) adjusted-hazard ratio (HR) 1.11 (p = 0.001) in 10 ≤ ΔSBP < 20 (mmHg) group; (ii) adjusted-HR 1.40 (p < 0.001) in 20 ≤ ΔSBP < 40 group; and (iii) adjusted-HR 1.88 (p < 0.001) in 40 ≤ ΔSBP group as compared with the reference group (- 10 ≤ ΔSBP < 10). Temporal increase in diastolic blood pressure (DBP) also a showed significant association with SCA risk with the highest risk observed in ∆DBP ≥ 25 group (adjusted-HR 1.61; p < 0.001) as compared with the reference group (- 5 ≤ ΔDBP < 5). The association between SBP and SCA was not affected by age, sex, presence of diabetes mellitus, or baseline SBP. In conclusion, a temporal increase in blood pressure was significantly associated with the occurrence of SCA, and this association was consistent across all subgroups. However, a temporary decrease in blood pressure does not reduce the risk of SCA. Prevention of elevated blood pressure may play an important role in preventing SCA.
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