Clinical benefit of treatment of stage-1, low-risk hypertension Korean national health insurance database analysis

Chan Joo Lee, Jiin Ryu, Hyeon Chang Kim, Dong Ryeol Ryu, Sang Hyun Ihm, Yong Jin Kim, Jin Ho Shin, Wook Bum Pyun, Hyoung Soo Kang, Jong Heon Park, Jinseub Hwang, Sungha Park

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6 Citations (Scopus)

Abstract

Evidence about the benefits of treating uncomplicated, low-risk, stage-1 hypertension is lacking. The study aimed to investigate the association between mean blood pressure (BP) and clinical outcomes, and to determine optimal BPs in treated, low-risk, stage-1 hypertension. From the National Health Insurance Service Health Examination Database, patients with stage-1 hypertension between 2005 and 2006 were selected. They had a systolic BP of 140 to 159 mm Hg or diastolic BP of 90 to 99 mm Hg. Patients were grouped as controlled (mean BP <140/90 mm Hg; n=99 301) and uncontrolled (mean BP ≥140/90 mm Hg; n=49 460) according to their mean BP recorded during the follow-up health examination. All-cause mortality and cardiovascular outcomes were examined. Mean BPs in the controlled and uncontrolled groups were 131.1/80.9 and 144.6/86.8 mm Hg, respectively. Controlled BP was associated with significantly lower risks of all-cause mortality, all stroke, hemorrhagic stroke, ischemic stroke, and end-stage renal disease. Subgroup analysis demonstrated benefits of controlled BP in hypertensive patients aged <50 years for all-cause mortality, all stroke, hemorrhagic stroke, ischemic stroke, and end-stage renal disease, with no significant interaction according to age. The BP associated with the lowest risk of all-cause mortality was 120 to <130 mm Hg (systolic BP) and 70 to <80 mm Hg (diastolic BP). There was an increased risk of myocardial infarction in patients with mean systolic BP <120 mm Hg and diastolic BP <80 mm Hg. BP <140/90 mm Hg was associated with a significant reduction in the risk of mortality, stroke, and end-stage renal disease, with the lowest mortality risk at BP ranges of 120 to <130 and 70 to <80 mmHg.

Original languageEnglish
Pages (from-to)1285-1293
Number of pages9
JournalHypertension
Volume72
Issue number6
DOIs
Publication statusPublished - 2018 Dec

All Science Journal Classification (ASJC) codes

  • Internal Medicine

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    Lee, C. J., Ryu, J., Kim, H. C., Ryu, D. R., Ihm, S. H., Kim, Y. J., Shin, J. H., Pyun, W. B., Kang, H. S., Park, J. H., Hwang, J., & Park, S. (2018). Clinical benefit of treatment of stage-1, low-risk hypertension Korean national health insurance database analysis. Hypertension, 72(6), 1285-1293. https://doi.org/10.1161/HYPERTENSIONAHA.118.11787