| アブストラクト | Background The 2017 American College of Cardiology (ACC)/American Heart Association (AHA) guidelines lowered the threshold of blood pressure (BP) for hypertension to 130/80 mm Hg. However, the clinical significance of isolated diastolic hypertension (IDH) according to the cutoff value of the 2017 ACC/AHA guidelines was uncertain. Methods and Results We analyzed the claims database of Japan Medical Data Center (a nationwide epidemiological database). We excluded individuals who were aged <20 years, had systolic hypertension, were taking antihypertensive medication, or had prevalent cardiovascular disease, and studied 1 746 493 individuals (mean age, 42.9+/-10.7 years; 961 097 men [55.0%]). The average observational period was 1107+/-855 days. Stage 1 IDH, defined as diastolic BP 80 to 89 mm Hg, and stage 2 IDH, defined as diastolic BP >/=90 mm Hg, were found in 230 513 (13.2%) and 16 159 (0.9%) individuals, respectively. Compared with individuals with normal diastolic BP, individuals with stage 1 and stage 2 IDH were older and more likely to be men. Prevalence of classic risk factors was higher in patients with IDH. Kaplan-Meier curves showed that stage 1 and stage 2 IDH were associated with a higher incidence of cardiovascular events, defined as myocardial infarction, angina pectoris, and stroke. Multivariable analysis showed that stage 1 (hazard ratio [HR], 1.17) and stage 2 (HR, 1.28) IDH were independently associated with a higher incidence of cardiovascular events. Subgroup analyses showed that the association of IDH with cardiovascular events was seen irrespective of age and sex. Conclusions The analysis of a nationwide epidemiological database showed that IDH based on the cutoff value in the 2017 ACC/AHA BP guidelines was associated with an elevated risk of subsequent cardiovascular events. |
|---|
| ジャーナル名 | Journal of the American Heart Association |
|---|
| 投稿日 | 2020/10/1 |
|---|
| 投稿者 | Kaneko, Hidehiro; Itoh, Hidetaka; Yotsumoto, Haruki; Kiriyama, Hiroyuki; Kamon, Tatsuya; Fujiu, Katsuhito; Morita, Kojiro; Michihata, Nobuaki; Jo, Taisuke; Takeda, Norifumi; Morita, Hiroyuki; Yasunaga, Hideo; Komuro, Issei |
|---|
| 組織名 | The Department of Cardiovascular Medicine The University of Tokyo Japan.;The Department of Advanced Cardiology The University of Tokyo Japan.;The Department of Clinical Epidemiology and Health Economics School of Public;Health The University of Tokyo Japan.;The Department of Health Services Research Faculty of Medicine University of;Tsukuba Japan.;The Department of Health Services Research The University of Tokyo Japan. |
|---|
| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/32993440/ |
|---|
