| アブストラクト | BACKGROUND: The association between stage 1 hypertension and the risk of cardiovascular disease (CVD) has not been established in older adults. Furthermore, little is known about whether lowering blood pressure (BP) is beneficial in older adults with stage 1 hypertension. METHODS: This cohort study analyzed nationwide data collected from the Japanese DeSC database, including 476,654 individuals aged >/=60 years. Individuals were categorized into four groups according to the 2017 ACC/AHA BP guidelines: normal BP, elevated BP, stage 1 hypertension, and stage 2 hypertension. The primary outcome was a composite CVD event, including myocardial infarction, angina pectoris, stroke, and heart failure. RESULTS: During a mean follow-up of 3.1 years, 53,946 composite CVD events were recorded. Hazard ratios of stage 1 hypertension for composite CVD events, myocardial infarction, angina pectoris, stroke, and heart failure were 1.10 (95 % CI, 1.07-1.13), 1.16 (95 % CI, 1.03-1.31), 1.06 (95 % CI, 1.01-1.10), 1.13 (95 % CI, 1.08-1.18), and 1.13 (95 % CI, 1.09-1.16), respectively. Individuals with a >/=5 mmHg decrease in systolic BP over one year had a lower risk of stroke among individuals with stage 1 hypertension. The positive association between stage 1 hypertension and composite CVD events was attenuated in individuals aged >/=75 years. CONCLUSIONS: Stage 1 hypertension is associated with a higher risk of developing CVD events among older adults. The 2017 ACC/AHA BP guidelines could be applied to older populations; however, the applicability of these guidelines to older adults aged >/=75 years requires further investigations. |
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| ジャーナル名 | Journal of cardiology |
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| 投稿日 | 2024/7/28 |
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| 投稿者 | Suzuki, Yuta; Kaneko, Hidehiro; Okada, Akira; Fujiu, Katsuhito; Takeda, Norifumi; Morita, Hiroyuki; Yano, Yuichiro; Nishiyama, Akira; Node, Koichi; Yasunaga, Hideo; Komuro, Issei |
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| 組織名 | The Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan;;Center for Outcomes Research and Economic Evaluation for Health, National;Institute of Public Health, Saitama, Japan.;The Department of Advanced Cardiology, The University of Tokyo, Tokyo, Japan.;Electronic address: kanekohidehiro@gmail.com.;Department of Prevention of Diabetes and Lifestyle-Related Diseases, Graduate;School of Medicine, The University of Tokyo, Tokyo, Japan.;The Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan.;Department of General Medicine, Juntendo University Faculty of Medicine, Tokyo,;Japan; Department of Family Medicine and Community Health, Duke University,;Durham, NC, USA.;Department of Pharmacology, Faculty of Medicine, Kagawa University, Kagawa,;Japan.;Department of Cardiovascular Medicine, Saga University, Saga, Japan.;The Department of Clinical Epidemiology and Health Economics, School of Public;Health, The University of Tokyo, Tokyo, Japan.;Department of Frontier Cardiovascular Science, Graduate School of Medicine, The;University of Tokyo, Tokyo, Japan; International University of Health and;Welfare, Tokyo, Japan. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/39067569/ |
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