Applying the 2024 European Society of Cardiology Guidelines for the management of elevated blood pressure and hypertension to a Norwegian general population cohort from age 40: data from the Akershus Cardiac Examination 1950 study.
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引用次数: 0
Abstract
Background: The 2024 European Society of Cardiology (ESC) Guidelines for hypertension introduced the 'elevated BP' (eBP) category (120-139/70-89 mm Hg). Individuals with persistent eBP (130-139/80-89 mm Hg), despite lifestyle intervention, may be recommended pharmacological treatment in case of concomitant elevated cardiovascular (CV) risk. We aimed to assess the impact of these updated recommendations on treatment eligibility at ages 40 and 62-65 and to examine the CV event rates over 30 years of follow-up, focusing on those with eBP (130-139/80-89 mm Hg) eligible for pharmacological treatment.
Methods: Data from individuals born in 1950 who participated in the Age 40 Programme and the Akershus Cardiac Examination 1950 Study was linked to national health registries. These data include BP measurements at age 40 (1990-1991) and 62-65 (2012-2015), assessment of elevated CV risk based on Systematic Coronary Risk Evaluation 2 (SCORE2) and outcomes of major adverse cardiovascular events (MACEs) tracked through 2022.
Results: At age 40, 854 (32%) of 2688 individuals had eBP (130-139/80-89 mm Hg), but only 4 had elevated CV risk warranting pharmacological treatment. At age 62-65, 1657 (61%) were on BP-lowering medication or had a BP ≥140/90, while 64 (8%) out of 851 with eBP were eligible for drug treatment. Based on BP values at age 40, only 2 of the 93 MACEs in the eBP (130-139/80-89 mm Hg) category occurred among those eligible for pharmacological treatment.
Conclusions: A single BP measurement at age 40 identified eBP (130-139/80-89 mm Hg) among one-third of the individuals, yet MACE cases within the eBP category occurred primarily in individuals who were not eligible for medical treatment.
背景：2024年欧洲心脏病学会（ESC）高血压指南引入了“血压升高”（eBP）类别（120-139/70-89 mm Hg）。对于持续性eBP （130-139/80-89 mm Hg）患者，尽管进行了生活方式干预，但如果合并心血管（CV）风险升高，可能建议进行药物治疗。我们的目的是评估这些更新建议对40岁和62-65岁患者治疗资格的影响，并检查30年随访期间的CV事件发生率，重点关注eBP （130-139/80-89 mm Hg）符合药物治疗条件的患者。方法：1950年出生、参加40岁计划和1950年Akershus心脏检查研究的个体的数据与国家健康登记处相关联。这些数据包括40岁（1990-1991年）和62-65岁（2012-2015年）时的血压测量，基于系统性冠状动脉风险评估2 （SCORE2）的心血管风险升高评估，以及追踪至2022年的主要不良心血管事件（mace）结局。结果：在40岁时，2688人中有854人（32%）有eBP (130-139/80-89 mm Hg)，但只有4人有CV风险升高，需要药物治疗。在62-65岁时，1657人（61%）接受降压药物治疗或血压≥140/90，而851名eBP患者中有64人（8%）符合药物治疗条件。根据40岁时的血压值，eBP （130-139/80-89 mm Hg）类别的93例mace中只有2例发生在符合药物治疗条件的人群中。结论：40岁时的单一血压测量在三分之一的个体中发现了eBP（130-139/80-89毫米汞柱），然而eBP类别中的MACE病例主要发生在不符合医疗条件的个体中。
期刊介绍：
Heart is an international peer reviewed journal that keeps cardiologists up to date with important research advances in cardiovascular disease. New scientific developments are highlighted in editorials and put in context with concise review articles. There is one free Editor’s Choice article in each issue, with open access options available to authors for all articles. Education in Heart articles provide a comprehensive, continuously updated, cardiology curriculum.
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