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Ideal Cardiovascular Health Metrics and Fatal Major Adverse Cardiovascular Events in Hypertensive Patients With Blood
Shanshan Shi1,2, Weihua Chen3, Lin Deng1
1Department of Cardiology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan 364000, China.
Insights
Adhering to Ideal Cardiovascular Health Metrics (ICVHMs) significantly lowers major adverse cardiovascular event (MACE) mortality risk in hypertensive patients. Maintaining multiple ICVHMs is crucial for cardiovascular health.
Area of Science:
- Cardiology
- Public Health
- Preventive Medicine
Background:
- High blood pressure (BP) is a primary risk factor for cardiovascular disease (CVD).
- Ideal Cardiovascular Health Metrics (ICVHMs) positively impact cardiovascular health.
- This study investigates the link between ICVHMs and hypertension-related CVD risk across BP ranges.
Purpose of the Study:
- To examine the association between ICVHMs and the risk of hypertension-related CVD events.
- To analyze this association in hypertensive patients across different blood pressure (BP) ranges.
- To determine the impact of ideal cardiovascular health metrics on major adverse cardiovascular event (MACE) mortality.
Main Methods:
- Analysis of 31,427 adults from the National Health and Nutrition Examination Survey (NHANES) 2005-2018.
- BP target set at <130/80 mmHg; ICVHMs defined by the 2022 American Heart Association Presidential Advisory.
- Cox proportional hazards models used to calculate Hazard Ratios (HR) and 95% Confidence Intervals (CI) for MACE mortality.
Main Results:
- Hypertensive patients with ≥5 ICVHMs showed no significantly additional MACE mortality risk compared to non-hypertensives (BP at target: HR 1.09; BP above target: HR 0.98).
- Compared to those with 0-1 ICVHMs, patients with ≥5 ICVHMs had lower MACE mortality risk (BP at target: HR 0.60; BP above target: HR 0.43).
- Each additional ICVHM correlated with reduced MACE mortality risk in hypertensive patients (BP at target: HR 0.86; BP above target: HR 0.84), even with high CVD risk factors.
Conclusions:
- Hypertensive patients with fewer ICVHMs face significantly higher MACE mortality risk.
- This elevated risk persists regardless of blood pressure control status.
- Achieving ideal cardiovascular health metrics is vital for mitigating CVD risk in hypertensive individuals.
Background:
High blood pressure (BP) is a major risk factor for cardiovascular disease (CVD) events. The ideal cardiovascular health metrics (ICVHMs) have beneficial effects on the cardiovascular system. The present study examined the association between ICVHMs and the risk of hypertension-related CVD in hypertensive patients across different BP ranges.
Methods:
Analyses included 31,427 adults from the National Health and Nutrition Examination Survey 2005-2018. The BP target was < 130/80 mm Hg and ICVHMs were defined based on the 2022 American Heart Association Presidential Advisory. Fatal major adverse cardiovascular events (MACE) were the primary outcomes. Cox proportional hazards models were used to calculate the HR and 95% CI for MACE mortality.
Results:
Among 31,427 participants, hypertensive patients with ≥ 5 ICVHMs did not appear significantly additional risk of MACE mortality compared to participants without hypertension (BP at target: HR, 1.09; 95% CI, 0.72-1.64; BP above target: HR, 0.98; 95% CI, 0.69-1.39). Compared to patients with 0-1 ICVHMs, experiencing ≥ 5 ICVHMs was associated with a lower MACE mortality risk (BP at target: HR, 0.60; 95% CI, 0.36-0.98; BP above target: HR, 0.43; 95% CI, 0.30-0.62). Among hypertensive patients, each increase in the number of ICVHMs was associated with a lower risk of MACE mortality (BP at target: HR, 0.86; 95% CI, 0.76-0.97; BP above target: HR, 0.84; 95% CI, 0.78-0.91), even in patients with high-risk factors for CVD.
Conclusions:
Compared to participants without hypertension, hypertensive patients with fewer ICVHMs, regardless of whether their blood pressure is well-controlled, face a significantly higher risk of MACE mortality.
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