Stage 1 hypertension was not significantly associated with increased 10-year cardiovascular mortality compared to normal blood pressure (HR 0.93; 95% CI 0.61-1.44; P=0.76).
Cohort (n=11,603)
Does Stage 1 hypertension (130-139/80-89 mmHg) associate with increased 10-year cardiovascular mortality compared to normal blood pressure in a population-based cohort?
Lowering the hypertension cut-off to 130/80 mmHg substantially increases prevalence but does not identify a population with significantly higher 10-year cardiovascular mortality, while potentially increasing negative labeling effects like depressed mood.
Hazard Ratio: 0.93 (95% CI 0.61–1.44)
p-value: p=0.76
AIMS: To investigate the clinical value of a lower blood pressure (BP) cut-off for Stage 1 (S1) hypertension (130-139 mmHg systolic or 80-89 mmHg diastolic) in comparison to the currently established Stage 2 (S2) cut-off (≥140/90 mmHg) in a population-based cohort. METHODS AND RESULTS: We assessed the hypertension prevalence and associated cardiovascular disease (CVD) events in a sample of 11 603 participants (52% men, 48% women; mean 47.6 years) from the MONICA/KORA prospective study. The implementation of the new S1 cut-off increased the prevalence of hypertension from 34% to 63%. Only 24% of S2 hypertension patients were under treatment. Within a follow-up period of 10 years (70 148 person-years), 370 fatal CVD events were observed. The adjusted CVD-specific mortality rate per 1000 persons was 1.61 95% confidence interval (CI) 1.10-2.25 cases in S2 and 1.07 (95% CI 0.71-1.64) cases in S1 hypertension in comparison to normal BP. Cox proportional regression models were significant for the association of S2 and CVD mortality (1.54, 95% CI 1.04-2.28, P = 0.03), also in the presence of competing risks (1.47, P = 0.05). However, statistical significance for S1 hypertension was not reached (0.93, 95% CI 0.61-1.44, P = 0.76). Among S2 participants, there was a significantly higher prevalence of depressed-mood in treated patients (47%) in comparison to non-treated patients (33%) (P < 0.0001). CONCLUSION: The lower BP cut-off substantially increased hypertension prevalence, while capturing a population with lower CVD mortality. Additionally, participants under treatment were more likely to have depressed-mood in comparison to non-treated participants, which might reflect a negative labelling effect.
Atasoy et al. (Mon,) conducted a cohort in Hypertension (n=11,603). Stage 1 hypertension (130-139/80-89 mmHg) vs. Normal blood pressure was evaluated on Cardiovascular disease (CVD) mortality (HR 0.93, 95% CI 0.61-1.44, p=0.76). Stage 1 hypertension was not significantly associated with increased 10-year cardiovascular mortality compared to normal blood pressure (HR 0.93; 95% CI 0.61-1.44; P=0.76).