Cardiovascular risk of isolated systolic or diastolic hypertension in subjects with abnormal glucose metabolism

doi:10.3969/j.issn.1006-7795.2023.01.007

Abstract

Abstract: Objective To explore whether cardiovascular risk differ among the subgroups of abnormal glucose metabolism adults with isolated systolic hypertension (ISH), isolated diastolic hypertension (IDH) or systolic and diastolic hypertension(SDH). Methods This study included 24 605 participants from Kailuan Study during 2006 and 2007, without taking antihypertensive medication and free of a history of cardiovascular disease (CVD). The baseline blood pressure (BP) was measured. The participants were categorized as having normal BP [systolic BP(SBP)<120 mmHg(1 mmHg=0.133 kPa)/diastolic BP (DBP)<80 mmHg], elevated BP (SBP 120－129 mmHg/DBP<80 mmHg), stage 1 IDH (SBP<130 mmHg/DBP 80－89 mmHg), stage 1 ISH (SBP 130－139 mmHg/DBP<80 mm Hg); stage 1 SDH (SBP 130－139 mmHg/DBP 80－89 mmHg), stage 2 IDH (SBP<140 mmHg/DBP≥90 mm Hg), stage 2 ISH (SBP≥140 mmHg/DBP<90 mm Hg), and stage 2 SDH (SBP≥140 mmHg/DBP≥90 mmHg). The outcome was the first occurrence of CVD from baseline to the end of follow-up (December 31, 2019). Multivariable-adjusted Cox proportional hazards models were performed to evaluate the associations. Results During a median follow-up of 12.9 (interquartile range: 12.5－13.1) years, we observed 2,406 incident CVD events. With normal BP as the reference, multivariable-adjusted hazard ratios for CVD events were 1.31 (95%CI 0.96－1.79) for stage 1 ISH, 1.15 (95%CI 0.96－1.37) for stage 1 IDH, and 1.30 (95%CI 1.07－1.57) for stage 1 SDH. Furthermore, stage 2 ISH, stage 2 IDH and stage 2 SDH all had a higher risk of CVD than the normal BP. The risk of CVD in stage 2 SDH was 2.24 times higher than normal BP (95% CI 1.91－2.61). Conclusions Categorizing abnormal glucose metabolism adults with stage 1 hypertension further into stage 1 ISH, IDH, and SDH may improve risk stratification for identifying high-risk individuals.

Key words: blood pressure, cardiovascular disease, hypertension, abnormal glucose metabolism

CLC Number:

Zuo Yingting, Wu Shouling, Chen Shuohua, Tian Xue, Xu Qin, Zhang Yijun, Zhang Xiaoli, Wang Anxin. Cardiovascular risk of isolated systolic or diastolic hypertension in subjects with abnormal glucose metabolism[J]. Journal of Capital Medical University, 2023, 44(1): 42-48.

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URL: https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/10.3969/j.issn.1006-7795.2023.01.007

https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/Y2023/V44/I1/42

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