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Blood pressure categories defined by the 2017 ACC/AHA guideline and all-cause mortality: a national cohort study in China and meta-analysis.
- Source :
-
Journal of human hypertension [J Hum Hypertens] 2022 Jan; Vol. 36 (1), pp. 95-105. Date of Electronic Publication: 2021 Feb 15. - Publication Year :
- 2022
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Abstract
- The 2017 American College of Cardiology/American Heart Association guideline recommends a lowered threshold for hypertension diagnosis. Nonetheless, the association of blood pressure (BP) groups defined by the new guideline and all-cause mortality has not been fully estimated, especially in general Chinese. Based on the China Health and Retirement Longitudinal Study (CHARLS) during 2011-2018, 12,964 participants aged 45 years or older at baseline were enrolled for a follow-up of 7 years. Cox proportional hazards models were used to examine the relationship of BP classifications with all-cause mortality, with normal BP (<120/80 mmHg) as a reference. Afterwards, eligible studies shed light in this field were searched in public databases, and meta-analysis was conducted. In CHARLS, there were 41.21% and 16.08% individuals with stage 2 hypertension and stage 1 hypertension, respectively. During the follow-up, 1293 death occurred. The redefined stage 1 (130-139/80-89 mmHg) and stage 2 hypertension (≥140/≥90 mmHg) were found to have increased risk of death in the crude model, but only stage 2 hypertension maintained statistically significance after adjustment. Furthermore, meta-analysis including CHARLS and nine other prospective studies, with a total of 290,609 participants followed up for 3,081,532 person-years, resulted in similar results (combined hazard ratio (95% confidence interval) was 1.07 (0.99-1.15) for stage 1 hypertension, and 1.39 (1.25-1.53) for stage 2 hypertension). The present study detected that individuals with stage 2 and stage 1 hypertension had increased likelihood to die from any cause, but only the former association achieved statistically significance. Further cohorts with long-term follow-up duration are warranted, especially in China.<br /> (© 2021. The Author(s), under exclusive licence to Springer Nature Limited part of Springer Nature.)
Details
- Language :
- English
- ISSN :
- 1476-5527
- Volume :
- 36
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Journal of human hypertension
- Publication Type :
- Academic Journal
- Accession number :
- 33589762
- Full Text :
- https://doi.org/10.1038/s41371-021-00495-7