Association of optimal blood pressure with mortality in patients taking antihypertensive medications

Dong Ho Yun; Hye Sun Lee; Won Jun Choi; Hyuk Jae Chang; Da Hye Son; Ji Won Lee

doi:10.1111/jch.14034

Association of optimal blood pressure with mortality in patients taking antihypertensive medications

Dong Ho Yun, Hye Sun Lee, Won Jun Choi, Hyuk Jae Chang, Da Hye Son, Ji Won Lee

Department of Internal Medicine

Research output: Contribution to journal › Article › peer-review

2 Citations (Scopus)

Abstract

We investigated the relationship between blood pressure (BP) and mortality in patients taking antihypertensive medications in the Korean using data from the 2007-2015 Korean National Health and Nutrition Examination Surveys. A total of 6601 patients aged 30-74 years were included. Systolic BP (SBP) and diastolic BP (DBP) were both divided into four groups as follows: SBP < 120, 120 ≤ SBP ≤ 129 130 ≤ SBP ≤ 139, and SBP ≥ 140; DBP < 70, 70 ≤ DBP ≤ 79, 80 ≤ DBP ≤ 89, and DBP ≥ 90. The survival rates and hazard ratios were evaluated using Kaplan-Meier curves and multivariable Cox regression analyses. To evaluate the predictability of all-cause mortality according to SBP and/or DBP, we calculated Harrell's concordance-index. The lowest DBP group had a high risk of mortality regardless of the SBP status. The group with DBP < 70 mm Hg and SBP ≥ 140 mm Hg showed the highest mortality. The discriminatory ability calculated using Harrell's C-indexes was greater for the combination of SBP and DBP compared to DBP or SBP alone. These results suggest that it is more effective to simultaneously evaluate the effect of SBP and DBP to predict mortality; clinicians should manage DBP < 70 mm Hg when treating hypertensive patients.

Original language	English
Pages (from-to)	2035-2043
Number of pages	9
Journal	Journal of Clinical Hypertension
Volume	22
Issue number	11
DOIs	https://doi.org/10.1111/jch.14034
Publication status	Published - 2020 Nov

Bibliographical note

Funding Information:
This work was supported by the Technology Innovation Program (20002781, A Platform for Prediction and Management of Health Risk Based on Personal Big Data and Lifelogging) funded by the Ministry of Trade, Industry & Energy (MOTIE, Korea). This work was supported by the pilot study of the Korea National Health and Nutrition Examination Survey linked Cause of death data by the Korea Centers for Disease Control and Prevention.

Funding Information:
This work was supported by the Technology Innovation Program (20002781, A Platform for Prediction and Management of Health Risk Based on Personal Big Data and Lifelogging) funded by the Ministry of Trade, Industry & Energy (MOTIE, Korea). This work was supported by the pilot study of the Korea National Health and Nutrition Examination Survey linked Cause of death data by the Korea Centers for Disease Control and Prevention. This work was supported by the pilot study of the Korea National Health and Nutrition Examination Survey linked Cause of death data by the Korea Centers for Disease Control and Prevention.

Funding Information:
This work was supported by the pilot study of the Korea National Health and Nutrition Examination Survey linked Cause of death data by the Korea Centers for Disease Control and Prevention.

Publisher Copyright:
© 2020 Wiley Periodicals LLC

All Science Journal Classification (ASJC) codes

Internal Medicine
Endocrinology, Diabetes and Metabolism
Cardiology and Cardiovascular Medicine

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1111/jch.14034

Cite this

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title = "Association of optimal blood pressure with mortality in patients taking antihypertensive medications",

abstract = "We investigated the relationship between blood pressure (BP) and mortality in patients taking antihypertensive medications in the Korean using data from the 2007-2015 Korean National Health and Nutrition Examination Surveys. A total of 6601 patients aged 30-74 years were included. Systolic BP (SBP) and diastolic BP (DBP) were both divided into four groups as follows: SBP < 120, 120 ≤ SBP ≤ 129 130 ≤ SBP ≤ 139, and SBP ≥ 140; DBP < 70, 70 ≤ DBP ≤ 79, 80 ≤ DBP ≤ 89, and DBP ≥ 90. The survival rates and hazard ratios were evaluated using Kaplan-Meier curves and multivariable Cox regression analyses. To evaluate the predictability of all-cause mortality according to SBP and/or DBP, we calculated Harrell's concordance-index. The lowest DBP group had a high risk of mortality regardless of the SBP status. The group with DBP < 70 mm Hg and SBP ≥ 140 mm Hg showed the highest mortality. The discriminatory ability calculated using Harrell's C-indexes was greater for the combination of SBP and DBP compared to DBP or SBP alone. These results suggest that it is more effective to simultaneously evaluate the effect of SBP and DBP to predict mortality; clinicians should manage DBP < 70 mm Hg when treating hypertensive patients.",

author = "Yun, {Dong Ho} and Lee, {Hye Sun} and Choi, {Won Jun} and Chang, {Hyuk Jae} and Son, {Da Hye} and Lee, {Ji Won}",

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AU - Lee, Hye Sun

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AU - Chang, Hyuk Jae

AU - Son, Da Hye

AU - Lee, Ji Won

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PY - 2020/11

Y1 - 2020/11

N2 - We investigated the relationship between blood pressure (BP) and mortality in patients taking antihypertensive medications in the Korean using data from the 2007-2015 Korean National Health and Nutrition Examination Surveys. A total of 6601 patients aged 30-74 years were included. Systolic BP (SBP) and diastolic BP (DBP) were both divided into four groups as follows: SBP < 120, 120 ≤ SBP ≤ 129 130 ≤ SBP ≤ 139, and SBP ≥ 140; DBP < 70, 70 ≤ DBP ≤ 79, 80 ≤ DBP ≤ 89, and DBP ≥ 90. The survival rates and hazard ratios were evaluated using Kaplan-Meier curves and multivariable Cox regression analyses. To evaluate the predictability of all-cause mortality according to SBP and/or DBP, we calculated Harrell's concordance-index. The lowest DBP group had a high risk of mortality regardless of the SBP status. The group with DBP < 70 mm Hg and SBP ≥ 140 mm Hg showed the highest mortality. The discriminatory ability calculated using Harrell's C-indexes was greater for the combination of SBP and DBP compared to DBP or SBP alone. These results suggest that it is more effective to simultaneously evaluate the effect of SBP and DBP to predict mortality; clinicians should manage DBP < 70 mm Hg when treating hypertensive patients.

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Association of optimal blood pressure with mortality in patients taking antihypertensive medications

Abstract

Bibliographical note

All Science Journal Classification (ASJC) codes

UN SDGs

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