Helen M Sheriff1, Apostolos Tsimploulis2, Miroslava Valentova3, Markus S Anker4, Prakash Deedwania5, Maciej Banach6, Charity J Morgan7, Marc R Blackman8, Gregg C Fonarow9, Michel White10, Kannayiram Alagiakrishnan11, Richard M Allman12, Wilbert S Aronow13, Stefan D Anker3, Ali Ahmed14. 1. Veterans Affairs Medical Center, Washington, DC, USA. 2. Veterans Affairs Medical Center, Washington, DC, USA; Georgetown University Hospital/Washington Hospital Center, Washington, DC, USA. 3. Department of Cardiology and Pneumology, University Medical Center Göttingen (UMG), Göttingen, Germany. 4. Charité Campus Benjamin Franklin, Department of Cardiology, Berlin, Germany. 5. University of California, San Francisco, Fresno, California, USA. 6. Medical University of Lodz, Lodz, Poland. 7. University of Alabama at Birmingham, Birmingham, AL, USA. 8. Veterans Affairs Medical Center, Washington, DC, USA; Georgetown University, Washington, DC, USA; George Washington University, Washington, DC, USA. 9. University of California, Los Angeles, California, USA. 10. Montreal Heart Institute, Montreal, Quebec, Canada. 11. University of Alberta, Alberta, Canada. 12. Department of Veterans Affairs, Geriatrics and Extended Care Services, Washington, DC, USA. 13. Westchester Medical Center and New York Medical College, Valhalla, NY, USA. 14. Veterans Affairs Medical Center, Washington, DC, USA; University of Alabama at Birmingham, Birmingham, AL, USA; George Washington University, Washington, DC, USA. Electronic address: aliahmedmdmph@gmail.com.
Abstract
BACKGROUND: Isolated systolic hypertension and isolated diastolic hypotension are common in older adults and associated with a higher risk of incident heart failure (HF). However, little is known about the prevalence and impact of isolated diastolic hypertension in this population. METHODS: In the Cardiovascular Health Study (CHS), of the 5776 community-dwelling older adults ≥65years who had data on baseline systolic and diastolic blood pressure (SBP and DBP), 28 had isolated diastolic hypertension (DBP ≥90mmHg and SBP <140mmHg). From the 5748 without isolated diastolic hypertension, we excluded those with SBP ≥120mmHg (n=4451), DBP 80-89mmHg (n=20), DBP <60mmHg (n=425), normal BP taking anti-hypertensive medications (n=311), normal BP taking no anti-hypertensive medications but with history of hypertension (n=38), and baseline HF (n=5). The final cohort of 524 participants included 27 with isolated diastolic hypertension. RESULTS: Patients (n=524) had a mean (±SD) age of 71 (±5) years, 58% were women and 9% African American. There were no significant between-group age or sex differences; 37% of those with isolated diastolic hypertension (versus 7% without) were African American. Incident HF occurred in 19% and 7% of participants with and without isolated diastolic hypertension, respectively (multivariable-adjusted hazard ratio {HR}, 4.65; 95% confidence interval {CI}, 1.09-19.90; p=0.038). There was a trend toward higher cardiovascular mortality (HR, 4.59; 95% CI, 0.92-23.88; p=0.063). CONCLUSION: Among community-dwelling older adults, isolated diastolic hypertension is rare and is associated with higher risk for incident HF and cardiovascular mortality. Published by Elsevier B.V.
BACKGROUND: Isolated systolic hypertension and isolated diastolic hypotension are common in older adults and associated with a higher risk of incident heart failure (HF). However, little is known about the prevalence and impact of isolated diastolic hypertension in this population. METHODS: In the Cardiovascular Health Study (CHS), of the 5776 community-dwelling older adults ≥65years who had data on baseline systolic and diastolic blood pressure (SBP and DBP), 28 had isolated diastolic hypertension (DBP ≥90mmHg and SBP <140mmHg). From the 5748 without isolated diastolic hypertension, we excluded those with SBP ≥120mmHg (n=4451), DBP 80-89mmHg (n=20), DBP <60mmHg (n=425), normal BP taking anti-hypertensive medications (n=311), normal BP taking no anti-hypertensive medications but with history of hypertension (n=38), and baseline HF (n=5). The final cohort of 524 participants included 27 with isolated diastolic hypertension. RESULTS:Patients (n=524) had a mean (±SD) age of 71 (±5) years, 58% were women and 9% African American. There were no significant between-group age or sex differences; 37% of those with isolated diastolic hypertension (versus 7% without) were African American. Incident HF occurred in 19% and 7% of participants with and without isolated diastolic hypertension, respectively (multivariable-adjusted hazard ratio {HR}, 4.65; 95% confidence interval {CI}, 1.09-19.90; p=0.038). There was a trend toward higher cardiovascular mortality (HR, 4.59; 95% CI, 0.92-23.88; p=0.063). CONCLUSION: Among community-dwelling older adults, isolated diastolic hypertension is rare and is associated with higher risk for incident HF and cardiovascular mortality. Published by Elsevier B.V.
Authors: Apostolos Tsimploulis; Helen M Sheriff; Phillip H Lam; Daniel J Dooley; Markus S Anker; Vasilios Papademetriou; Ross D Fletcher; Charles Faselis; Gregg C Fonarow; Prakash Deedwania; Michel White; Miroslava Valentova; Marc R Blackman; Maciej Banach; Charity J Morgan; Kannayiram Alagiakrishnan; Richard M Allman; Wilbert S Aronow; Stefan D Anker; Ali Ahmed Journal: Int J Cardiol Date: 2017-03-01 Impact factor: 4.164
Authors: Paulina Dziamałek-Macioszczyk; Joanna M Harazny; Norbert Kwella; Paweł Wojtacha; Susanne Jung; Thomas Dienemann; Roland E Schmieder; Tomasz Stompór Journal: Med Sci Monit Date: 2020-06-12