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Posted by on Jul 29, 2019 in Hypertension | 0 comments

In a nutshell

This study investigated if blood pressure (BP) levels are associated with cardiovascular events (CVEs).

They found that elevated systolic BP and diastolic BP increased the risk of CVEs.

Some background

Hypertension or high blood pressure (BP) is a common condition. Systolic BP (SBP) is the pressure in your heart when it contracts (beats). Diastolic BP (DBP) is the pressure in the heart between beats. Patients with hypertension may have elevated SBP, DBP or both. Managing hypertension is important. High BP over time may increase the risk of cardiovascular events (CVEs). CVEs include stroke, heart attack or death due to heart disease.

The guidelines on classifying hypertension have been revised. Patients with BP greater than 130/80 mm Hg rather than 140/90 mmHg are now high-risk. Some doctors have conflicting opinions on how high BP may influence CVE risk. It is unclear if elevated SBP or DBP is more important in determining the risk of CVEs. 

Methods & findings

This study included 1.3 million adults. Patient data were obtained from a database. The authors extracted information on patient care for hypertension and CVEs. BP measurements were also extracted. They analyzed the data to determine if there was any link between BP and CVEs. CVEs included stroke and heart attack

Increasing SBP was associated with greater CVE risk. This was true for both 140 mmHg and 130 mmHg. Increasing DBP was associated with also greater CVE risk. This was true for both 80 mmHg and 90 mmHg. SBP had a greater effect on CVE outcomes compared to DBP. The effect of DBP on CVE risk was also influenced by age and other factors. 

The bottom line

The authors concluded that elevated SBP and DBP increased the risk of CVEs. The authors support the recent changes in BP thresholds to tighten the BP control for high-risk patients.

The fine print

This was a retrospective study. Some information was not available. Diet was not included as a factor. Diet plays an important role in hypertension management. More investigation is needed.

What’s next?

If you have any concerns regarding hypertension management please consult with your doctor. 

Published By :

The New England Journal of Medicine

Date :

Jul 18, 2019

Original Title :

Effect of Systolic and Diastolic Blood Pressure on Cardiovascular Outcomes.

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