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Age and sex specific target of blood pressure for the prevention of cardiovascular event among the treatment naive hypertensive patients
The time at which hypertension treatment should be initiated for different age groups and sexes remains controversial. We aimed to determine whether the association between blood pressure (BP) and major adverse cardiovascular events (MACE) varies with age and sex. This study enrolled 327,328 subject...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Nature Publishing Group UK
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7726552/ https://www.ncbi.nlm.nih.gov/pubmed/33299061 http://dx.doi.org/10.1038/s41598-020-78641-3 |
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author | Kim, Hyoungnae Lee, Seulbi Ha, Eunhee Kwon, Soon Hyo Jeon, Jin Seok Noh, Hyunjin Han, Dong Cheol Oh, Hyung Jung Ryu, Dong-Ryeol |
author_facet | Kim, Hyoungnae Lee, Seulbi Ha, Eunhee Kwon, Soon Hyo Jeon, Jin Seok Noh, Hyunjin Han, Dong Cheol Oh, Hyung Jung Ryu, Dong-Ryeol |
author_sort | Kim, Hyoungnae |
collection | PubMed |
description | The time at which hypertension treatment should be initiated for different age groups and sexes remains controversial. We aimed to determine whether the association between blood pressure (BP) and major adverse cardiovascular events (MACE) varies with age and sex. This study enrolled 327,328 subjects who had not taken antihypertensive medication in the Korean National Health Service-National Health Screening Cohort between 2002 and 2003. Participants were categorized into four groups according to 2017 American College of Cardiology/American Heart Association hypertension guideline. Primary outcome was MACE characterized by cardiovascular mortality, myocardial infarction, unstable angina, and stroke. During a 10-year follow-up, a significant increase in MACE risk was observed from the stage 1 hypertension group (hazard ratio [HR], 1.23; 95% CI 1.15–1.32; P < 0.001) in time-varying Cox analysis. This relationship was persistent in subjects aged < 70 years, but increased MACE risk was observed only in the stage 2 hypertension group in ≥ 70 years (HR, 1.52; 95% CI 1.32–1.76, P < 0.001). When categorized as per sex, both men and women showed significant MACE risk from stage 1 hypertension. However, on comparing the sexes after stratifying by age, a significantly increased risk of MACE was shown from stage 1 hypertension in men aged < 50 years, but from stage 2 hypertension in men aged ≥ 50 years. Meanwhile, increased MACE risk was observed from stage 2 hypertension in women aged < 60 years, but from stage 1 hypertension in women aged ≥ 60 years. Thus, young male subjects had higher MACE risk than young female subjects, but this difference gradually decreased with age and there was no difference between sexes in subjects aged ≥ 70 years. Therefore, our results suggest that hypertension treatment initiation may need to be individualized depending on age and sex. |
format | Online Article Text |
id | pubmed-7726552 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Nature Publishing Group UK |
record_format | MEDLINE/PubMed |
spelling | pubmed-77265522020-12-14 Age and sex specific target of blood pressure for the prevention of cardiovascular event among the treatment naive hypertensive patients Kim, Hyoungnae Lee, Seulbi Ha, Eunhee Kwon, Soon Hyo Jeon, Jin Seok Noh, Hyunjin Han, Dong Cheol Oh, Hyung Jung Ryu, Dong-Ryeol Sci Rep Article The time at which hypertension treatment should be initiated for different age groups and sexes remains controversial. We aimed to determine whether the association between blood pressure (BP) and major adverse cardiovascular events (MACE) varies with age and sex. This study enrolled 327,328 subjects who had not taken antihypertensive medication in the Korean National Health Service-National Health Screening Cohort between 2002 and 2003. Participants were categorized into four groups according to 2017 American College of Cardiology/American Heart Association hypertension guideline. Primary outcome was MACE characterized by cardiovascular mortality, myocardial infarction, unstable angina, and stroke. During a 10-year follow-up, a significant increase in MACE risk was observed from the stage 1 hypertension group (hazard ratio [HR], 1.23; 95% CI 1.15–1.32; P < 0.001) in time-varying Cox analysis. This relationship was persistent in subjects aged < 70 years, but increased MACE risk was observed only in the stage 2 hypertension group in ≥ 70 years (HR, 1.52; 95% CI 1.32–1.76, P < 0.001). When categorized as per sex, both men and women showed significant MACE risk from stage 1 hypertension. However, on comparing the sexes after stratifying by age, a significantly increased risk of MACE was shown from stage 1 hypertension in men aged < 50 years, but from stage 2 hypertension in men aged ≥ 50 years. Meanwhile, increased MACE risk was observed from stage 2 hypertension in women aged < 60 years, but from stage 1 hypertension in women aged ≥ 60 years. Thus, young male subjects had higher MACE risk than young female subjects, but this difference gradually decreased with age and there was no difference between sexes in subjects aged ≥ 70 years. Therefore, our results suggest that hypertension treatment initiation may need to be individualized depending on age and sex. Nature Publishing Group UK 2020-12-09 /pmc/articles/PMC7726552/ /pubmed/33299061 http://dx.doi.org/10.1038/s41598-020-78641-3 Text en © The Author(s) 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Article Kim, Hyoungnae Lee, Seulbi Ha, Eunhee Kwon, Soon Hyo Jeon, Jin Seok Noh, Hyunjin Han, Dong Cheol Oh, Hyung Jung Ryu, Dong-Ryeol Age and sex specific target of blood pressure for the prevention of cardiovascular event among the treatment naive hypertensive patients |
title | Age and sex specific target of blood pressure for the prevention of cardiovascular event among the treatment naive hypertensive patients |
title_full | Age and sex specific target of blood pressure for the prevention of cardiovascular event among the treatment naive hypertensive patients |
title_fullStr | Age and sex specific target of blood pressure for the prevention of cardiovascular event among the treatment naive hypertensive patients |
title_full_unstemmed | Age and sex specific target of blood pressure for the prevention of cardiovascular event among the treatment naive hypertensive patients |
title_short | Age and sex specific target of blood pressure for the prevention of cardiovascular event among the treatment naive hypertensive patients |
title_sort | age and sex specific target of blood pressure for the prevention of cardiovascular event among the treatment naive hypertensive patients |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7726552/ https://www.ncbi.nlm.nih.gov/pubmed/33299061 http://dx.doi.org/10.1038/s41598-020-78641-3 |
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