Isolated Diastolic Hypertension in the IDACO Study: An Age-Stratified Analysis Using 24-Hour Ambulatory Blood Pressure Measurements

Authors

John W. McEvoy
Wen-Yi Yang
Lutgarde Thijs
Zhen-Yu Zhang
Jesus D. Melgarejo, The University of Texas Rio Grande ValleyFollow
José Boggia
Tine W. Hansen
Kei Asayama
Takayoshi Ohkubo
Gladys E. Maestre, The University of Texas Rio Grande ValleyFollow

Document Type

Article

Publication Date

10-4-2021

Abstract

The prognostic implications of isolated diastolic hypertension (IDH), as defined by 2017 American College of Cardiology (ACC)/American Heart Association (AHA) guidelines, have not been tested using ambulatory blood pressure (BP) monitor thresholds (ie, 24-hour mean systolic BP ≥75 mm Hg). We analyzed data from 11 135 participants in the IDACO (International Database on Ambulatory Blood Pressure in Relation to Cardiovascular Outcomes). Using 24-hour mean ambulatory BP monitor values, we performed Cox regression testing independent associations of IDH with death or cardiovascular events. Analyses were conducted in the cohort overall, as well as after age stratification (≥50 years). The median age at baseline was 54.7 years and 49% were female. Over a median follow-up of 13.8 years, 2836 participants died, and 2049 experienced a cardiovascular event. Overall, irrespective of age, IDH on 24-hour ambulatory BP monitor defined by 2017 American College of Cardiology/American Heart Association criteria was not significantly associated with death (hazard ratio, 0.95 [95% CI, 0.79–1.13]) or cardiovascular events (hazard ratio, 1.14 [95% CI, 0.94–1.40]), compared with normotension. However, among the subgroup old, IDH was associated with excess risk for cardiovascular events (2.87 [95% CI, 1.72–4.80]), with evidence for effect modification based on age (P interaction

Comments

Copyright © 2021 The Authors.

Recommended Citation

McEvoy JW, Yang WY, Thijs L, et al. Isolated Diastolic Hypertension in the IDACO Study: An Age-Stratified Analysis Using 24-Hour Ambulatory Blood Pressure Measurements. Hypertension. 2021;78(5):1222-1231. doi:10.1161/HYPERTENSIONAHA.121.17766

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.

Publication Title

Hypertension

DOI

10.1161/HYPERTENSIONAHA.121.17766

Academic Level

faculty

Mentor/PI Department

Neuroscience