Hyung Jung Oh1,2, Seulbi Lee3, Eun-Kyung Lee4, Oesook Lee4, Eunhee Ha3,5, Eun-Mi Park6,7, Seung-Jung Kim8, Duk-Hee Kang8, Kyu Bok Choi8, Seung Jun Kim9, Dong-Ryeol Ryu2,7,8. 1. a Ewha Institute of Convergence Medicine , Ewha Womans University Mokdong Hospital , Seoul , Korea. 2. b Research Institute for Human Health Information , Ewha Womans University Mokdong Hospital , Seoul , Korea. 3. c Department of Medical Science, School of Medicine , Ewha Womans University , Seoul , Korea. 4. d Department of Statistics , Ewha Womans University , Seoul , Korea. 5. e Department of Preventive Medicine, School of Medicine , Ewha Womans University , Seoul , Korea. 6. f Department of Pharmacology , Ewha Womans University , Seoul , Republic of Korea. 7. g Tissue Injury Defense Research Center, College of Medicine , Ewha Womans University , Seoul , Republic of Korea. 8. h Department of Internal Medicine, School of Medicine , Ewha Womans University , Seoul , Korea. 9. i Department of Internal Medicine , International St. Mary's Hospital, Catholic Kwandong University, College of Medicine , Incheon , Republic of Korea.
Abstract
BACKGROUND: The effects of each blood pressure index [systolic and diastolic blood pressure (SBP, DBP), pulse pressure (PP), mean arterial pressure (MAP)] on the occurrence of mortality and cardiovascular (CV) events have not yet been investigated in prehypertensive populations. METHODS: A total of 30,258 prehypertensive Korean participants underwent periodic health examination between 2003 and 2004 were enrolled, and the associations of BP components with mortality and CV events were investigated. Moreover, based on the DBP [80 ≤ DBP <90 mmHg (N = 21,323) and DBP <80 mmHg (N = 8,935)], the effects of BP components were also evaluated. RESULTS: Multivariate Cox analyses in prehypertensive group revealed that the hazard ratios (HRs) were 1.121 and 1.130 per 10 mmHg increase in SBP and PP for mortality, respectively. Additionally, 10 mmHg increase of SBP (HR:1.090) was still significantly, but increase of PP (HR:1.060) was marginally associated with higher incidence of CV events. However, there were no significant associations with increase in DBP or MAP on adverse clinical outcomes in prehypertensive group. In the prehypertensive subjects with DBP <80 mmHg, CV events more frequently occurred by 38.8% and 28.5% per 10 mmHg increase in SBP and PP, respectively. CONCLUSIONS: Prehypertensive subjects might need to be cautioned when they have high SBP or PP with low DBP even in healthy populations. Key message Prehypertensive subjects should be cautioned when they have high-systolic blood pressure or pulse pressure with low-diastolic blood pressure, even without previous hypertension, diabetes mellitus or chronic kidney disease.
BACKGROUND: The effects of each blood pressure index [systolic and diastolic blood pressure (SBP, DBP), pulse pressure (PP), mean arterial pressure (MAP)] on the occurrence of mortality and cardiovascular (CV) events have not yet been investigated in prehypertensive populations. METHODS: A total of 30,258 prehypertensive Korean participants underwent periodic health examination between 2003 and 2004 were enrolled, and the associations of BP components with mortality and CV events were investigated. Moreover, based on the DBP [80 ≤ DBP <90 mmHg (N = 21,323) and DBP <80 mmHg (N = 8,935)], the effects of BP components were also evaluated. RESULTS: Multivariate Cox analyses in prehypertensive group revealed that the hazard ratios (HRs) were 1.121 and 1.130 per 10 mmHg increase in SBP and PP for mortality, respectively. Additionally, 10 mmHg increase of SBP (HR:1.090) was still significantly, but increase of PP (HR:1.060) was marginally associated with higher incidence of CV events. However, there were no significant associations with increase in DBP or MAP on adverse clinical outcomes in prehypertensive group. In the prehypertensive subjects with DBP <80 mmHg, CV events more frequently occurred by 38.8% and 28.5% per 10 mmHg increase in SBP and PP, respectively. CONCLUSIONS:Prehypertensive subjects might need to be cautioned when they have high SBP or PP with low DBP even in healthy populations. Key message Prehypertensive subjects should be cautioned when they have high-systolic blood pressure or pulse pressure with low-diastolic blood pressure, even without previous hypertension, diabetes mellitus or chronic kidney disease.