收缩压低于130mmHg的老年人心血管风险与舒张压之间的关系：2014年至2022年的前瞻性队列研究

IF 3.4 3区医学 Q2 GERIATRICS & GERONTOLOGY

Aging Clinical and Experimental Research Pub Date : 2024-12-02 DOI:10.1007/s40520-024-02876-7

Jingjing Hou, Song Zhao, Jie Liu, Xiaoxia Xi, Yawei Xu, Shengfeng Shi, Shikai Yu, Yi Zhang, on behalf of the Northern Shanghai Study investigators

{"title":"收缩压低于130mmHg的老年人心血管风险与舒张压之间的关系：2014年至2022年的前瞻性队列研究","authors":"Jingjing Hou, Song Zhao, Jie Liu, Xiaoxia Xi, Yawei Xu, Shengfeng Shi, Shikai Yu, Yi Zhang, on behalf of the Northern Shanghai Study investigators","doi":"10.1007/s40520-024-02876-7","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>The 2017 American College of Cardiology (ACC)/American Heart Association (AHA) guideline lowered the diagnostic threshold for hypertension to a systolic/diastolic blood pressure (SBP/DBP) of 130/80 mmHg. However, the predictive value of DBP for cardiovascular (CV) risk assessment diminishes with aging. The study aimed to explore whether the new diagnostic threshold for diastolic hypertension is associated with increased risk of CV organ damage and major adverse cardiovascular events (MACEs) in older adults.</p><h3>Methods</h3><p>1181 individuals aged 65 years or older with SBP < 130 mmHg were enrolled a prospective cohort study. They were classified into Low (< 70 mmHg), Optimal (70 to < 80 mmHg), and High (80 to < 90 mmHg) DBP groups. Cardiac, vascular, and renal organ damage were measured at baseline. The endpoint of the study was MACEs.</p><h3>Results</h3><p>Among 1181 participants (average age 71.9 years, 44.8% men), 172 MACEs were observed during an average follow-up of 6.4 years. We found no significant differences in CV organ damage or MACEs rates (Log-rank <i>P</i> = 0.73) among three groups. In multivariable Cox regression, compared to the Optimal DBP group, no significant increase in CV risk was observed in the Low DBP group (hazard ratio [HR] 1.02, [95% CI 0.68–1.52], <i>P</i> = 0.93) or the High DBP group (HR 1.04, [95% CI 0.72–1.49], <i>P</i> = 0.85). Propensity score matching showed consistent results.</p><h3>Conclusion</h3><p>In older adults with SBP < 130 mmHg, DBP values 80–89 mmHg were not associated with higher risk of CV organ damage, events or mortality.</p></div>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":"36 1","pages":""},"PeriodicalIF":3.4000,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40520-024-02876-7.pdf","citationCount":"0","resultStr":"{\"title\":\"Association between cardiovascular risk and diastolic blood pressure in older adults with systolic blood pressure less than 130mmHg: a prospective cohort study from 2014 to 2022\",\"authors\":\"Jingjing Hou, Song Zhao, Jie Liu, Xiaoxia Xi, Yawei Xu, Shengfeng Shi, Shikai Yu, Yi Zhang, on behalf of the Northern Shanghai Study investigators\",\"doi\":\"10.1007/s40520-024-02876-7\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>The 2017 American College of Cardiology (ACC)/American Heart Association (AHA) guideline lowered the diagnostic threshold for hypertension to a systolic/diastolic blood pressure (SBP/DBP) of 130/80 mmHg. However, the predictive value of DBP for cardiovascular (CV) risk assessment diminishes with aging. The study aimed to explore whether the new diagnostic threshold for diastolic hypertension is associated with increased risk of CV organ damage and major adverse cardiovascular events (MACEs) in older adults.</p><h3>Methods</h3><p>1181 individuals aged 65 years or older with SBP < 130 mmHg were enrolled a prospective cohort study. They were classified into Low (< 70 mmHg), Optimal (70 to < 80 mmHg), and High (80 to < 90 mmHg) DBP groups. Cardiac, vascular, and renal organ damage were measured at baseline. The endpoint of the study was MACEs.</p><h3>Results</h3><p>Among 1181 participants (average age 71.9 years, 44.8% men), 172 MACEs were observed during an average follow-up of 6.4 years. We found no significant differences in CV organ damage or MACEs rates (Log-rank <i>P</i> = 0.73) among three groups. In multivariable Cox regression, compared to the Optimal DBP group, no significant increase in CV risk was observed in the Low DBP group (hazard ratio [HR] 1.02, [95% CI 0.68–1.52], <i>P</i> = 0.93) or the High DBP group (HR 1.04, [95% CI 0.72–1.49], <i>P</i> = 0.85). Propensity score matching showed consistent results.</p><h3>Conclusion</h3><p>In older adults with SBP < 130 mmHg, DBP values 80–89 mmHg were not associated with higher risk of CV organ damage, events or mortality.</p></div>\",\"PeriodicalId\":7720,\"journal\":{\"name\":\"Aging Clinical and Experimental Research\",\"volume\":\"36 1\",\"pages\":\"\"},\"PeriodicalIF\":3.4000,\"publicationDate\":\"2024-12-02\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://link.springer.com/content/pdf/10.1007/s40520-024-02876-7.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Aging Clinical and Experimental Research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://link.springer.com/article/10.1007/s40520-024-02876-7\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"GERIATRICS & GERONTOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Aging Clinical and Experimental Research","FirstCategoryId":"3","ListUrlMain":"https://link.springer.com/article/10.1007/s40520-024-02876-7","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GERIATRICS & GERONTOLOGY","Score":null,"Total":0}

引用次数: 0

摘要

2017年美国心脏病学会(ACC)/美国心脏协会（AHA）指南将高血压的诊断阈值降低至收缩压/舒张压（SBP/DBP） 130/80 mmHg。然而，舒张压对心血管（CV）风险评估的预测价值随着年龄的增长而降低。该研究旨在探讨舒张期高血压的新诊断阈值是否与老年人心血管器官损伤和主要不良心血管事件（mace）风险增加有关。方法1181例65岁及以上收缩压130 mmHg患者纳入前瞻性队列研究。他们被分为低（70毫米汞柱）、最佳（70至80毫米汞柱）和高（80至90毫米汞柱）DBP组。在基线时测量心脏、血管和肾器官损伤。研究终点为mace。结果在1181名参与者中（平均年龄71.9岁，男性44.8%），在平均6.4年的随访中观察到172例mace。我们发现三组间CV器官损伤或mace发生率无显著差异（Log-rank P = 0.73）。在多变量Cox回归中，与最佳DBP组相比，低DBP组（风险比[HR] 1.02, [95% CI 0.68-1.52], P = 0.93）或高DBP组（风险比[HR] 1.04, [95% CI 0.72-1.49], P = 0.85）的CV风险未见显著增加。倾向评分匹配结果一致。结论在收缩压和血压为130 mmHg的老年人中，舒张压值为80-89 mmHg与心血管器官损伤、事件或死亡的高风险无关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Association between cardiovascular risk and diastolic blood pressure in older adults with systolic blood pressure less than 130mmHg: a prospective cohort study from 2014 to 2022

Background

The 2017 American College of Cardiology (ACC)/American Heart Association (AHA) guideline lowered the diagnostic threshold for hypertension to a systolic/diastolic blood pressure (SBP/DBP) of 130/80 mmHg. However, the predictive value of DBP for cardiovascular (CV) risk assessment diminishes with aging. The study aimed to explore whether the new diagnostic threshold for diastolic hypertension is associated with increased risk of CV organ damage and major adverse cardiovascular events (MACEs) in older adults.

Methods

1181 individuals aged 65 years or older with SBP < 130 mmHg were enrolled a prospective cohort study. They were classified into Low (< 70 mmHg), Optimal (70 to < 80 mmHg), and High (80 to < 90 mmHg) DBP groups. Cardiac, vascular, and renal organ damage were measured at baseline. The endpoint of the study was MACEs.

Results

Among 1181 participants (average age 71.9 years, 44.8% men), 172 MACEs were observed during an average follow-up of 6.4 years. We found no significant differences in CV organ damage or MACEs rates (Log-rank P = 0.73) among three groups. In multivariable Cox regression, compared to the Optimal DBP group, no significant increase in CV risk was observed in the Low DBP group (hazard ratio [HR] 1.02, [95% CI 0.68–1.52], P = 0.93) or the High DBP group (HR 1.04, [95% CI 0.72–1.49], P = 0.85). Propensity score matching showed consistent results.

Conclusion

In older adults with SBP < 130 mmHg, DBP values 80–89 mmHg were not associated with higher risk of CV organ damage, events or mortality.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

Aging Clinical and Experimental Research 医学-老年医学

CiteScore

7.90

自引率

5.00%

发文量

283

审稿时长

1 months

期刊介绍： Aging clinical and experimental research offers a multidisciplinary forum on the progressing field of gerontology and geriatrics. The areas covered by the journal include: biogerontology, neurosciences, epidemiology, clinical gerontology and geriatric assessment, social, economical and behavioral gerontology. “Aging clinical and experimental research” appears bimonthly and publishes review articles, original papers and case reports.