New BP Treatment Cutoffs May Not Yield Survival Benefit
Survival benefit not seen with Stage 1 hypertension, only high-risk Stage 2 hypertension
(HealthDay News) -- New blood pressure treatment recommendations may not improve survival from cardiovascular disease (CVD), according to a study recently published in the European Heart Journal.
Seryan Atasoy, from the Ludwig-Maximilians-Universitüt München, and colleagues used data from 11,603 participants (52% men; mean age, 47.6 years) in the MONICA/KORA prospective study. The authors sought to evaluate the prevalence of hypertension and associated CVD events.
They found that implementation of the new Stage 1 cutoff (130 to 139 mm Hg systolic or 80 to 89 mm Hg diastolic) increased the prevalence of hypertension from 34 to 63%. Only 24% of Stage 2 hypertension patients (≥140/90 mm Hg) were receiving treatment. During 10 years of follow-up, there were 370 fatal CVD events. The adjusted CVD-specific mortality rate per 1000 persons was 1.61 (95% confidence interval, 1.10 to 2.25) and 1.07 (percent confidence interval, 0.71 to 1.64) in Stage 2 hypertension and Stage 1 hypertension cases, respectively, compared with those with normal blood pressure. The association of Stage 2 hypertension and CVD mortality was significant in Cox proportional regression models (1.54; 95% confidence interval, 1.04 to 2.28; P=0.03), while the association was not significant for Stage 1 hypertension (0.93; 95% confidence interval, 0.61 to 1.44; P=0.76).
"The lower BP cutoff substantially increased hypertension prevalence, while capturing a population with lower CVD mortality," the authors write.
Atasoy S, Johar H, Peters A, Ladwig KH. Association of hypertension cut-off values with 10-year cardiovascular mortality and clinical consequences: a real-world perspective from the prospective MONICA/KORA study. Eur Heart J. ehy694, DOI:10.1093/eurheartj/ehy694