Key result
Isolated diastolic hypertension shows no association with target organ damage compared to normotension.
Why the study?
The effective cardiovascular risk linked to isolated diastolic hypertension under the 2017 ACC/AHA guidelines remains debated.
Is isolated diastolic hypertension associated with target organ damage compared to normal blood pressure?
Cross-Sectional (n=1,605)
Is isolated diastolic hypertension associated with target organ damage compared to normal blood pressure?
Isolated diastolic hypertension, as defined by the 2017 ACC/AHA guidelines, is not significantly associated with target organ damage, suggesting it may contribute marginally to cardiovascular risk.
Answers are grounded in this paper and cite their sources.
IDH was not associated with target organ damage; hypothesis-generating and should not change practice pending longitudinal data.
Background Isolated diastolic hypertension (IDH) is defined as diastolic blood pressure (DBP) ≥80 mmHg and systolic blood pressure (SBP) <130 mmHg according to 2017 ACC/AHA guidelines. The effective cardiovascular risk linked to IDH is debated. Hypothesis IDH might contribute marginally to hypertension‐related target organ damage (TOD) development. Methods In this cross‐sectional analysis 1605 subjects from the STANISLAS cohort, a large familiar longitudinal study from Eastern France, were included. Participants were categorized according to average values at 24‐h ABP recording as having normal BP (SBP < 130/DBP < 80 mmHg); combined hypertension (SBP ≥130/DBP ≥80 mmHg or on antihypertensive treatment); IDH (SBP <130/DBP >80 mmHg); isolated systolic hypertension (ISH: SBP ≥130/DBP <80 mmHg). The association between hypertension status and TOD was assessed by multivariable‐adjusted logistic models. Results Using normotension as reference, IDH was not significantly associated with NTproBNP levels (adjusted odds ratio [OR] 1.04 [95%CI 0.82;1.32], p = .750), microalbuminuria (OR 0.99 [0.69; 1.42], p = .960), diastolic dysfunction (OR 1.53 [0.88; 2.68], p = .130), left ventricular (LV) mass index (OR per 10 g/m 2 increase 1.07 [0.95; 1.21], p = .250), LV longitudinal strain (global: OR 1.07 [0.99; 1.14], p = .054; subendocardial: OR 1.06 [0.99; 1.13], p = .087), carotid intima media thickness (OR 1.27 [0.79; 2.06], p = .320), reduced ankle‐brachial index (<0.9; OR 1.59 [0.19; 13.55], p = .670) and pulse wave velocity (PWV; OR 1.07 [0.93; 1.23], p = .360). In contrast, combined hypertension and ISH were independently associated with LV mass index and PWV increase (all p ≤ .01). Conclusions IDH was not significantly associated with TOD. Further studies are needed to clarify the clinical role of IDH. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT01391442.
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Monzo et al. (2021) conducted a cross-sectional in Isolated diastolic hypertension (n=1,605). Isolated diastolic hypertension vs. Normal blood pressure was evaluated on Target organ damage (e.g., NTproBNP levels) (OR 1.04, 95% CI 0.82-1.32, p=0.750). Isolated diastolic hypertension was not significantly associated with target organ damage, such as NTproBNP levels (OR 1.04; 95% CI 0.82-1.32; p=0.750), compared to normotension.
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