Key result
Isolated diastolic hypertension was not significantly associated with incident cardiovascular disease over 13 years in MESA (HR 1.19; 95% CI 0.77-1.84) or consistently in a meta-analysis of 8 cohorts.
Why the study?
Whether isolated diastolic hypertension defined by 2017 ACC/AHA guidelines is associated with cardiovascular disease has been disputed.
Is isolated diastolic hypertension defined by the 2017 ACC/AHA criteria associated with increased risk of cardiovascular disease events and subclinical CVD?
Population
5104 MESA participants and 10 037 843 participants across eight cohort studies
Comparison
2017 ACC/AHA isolated diastolic hypertension vs no isolated diastolic hypertension
Design
Cohort study and random-effects meta-analysis
Follow-up
13 years in MESA
Authors
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May not justify drug therapy for IDH; leaves open need for prospective trials under current BP targets.
Meta-Analysis (n=10,037,843)
Yes
Is isolated diastolic hypertension defined by the 2017 ACC/AHA criteria associated with increased risk of cardiovascular disease events and subclinical CVD?
Hazard Ratio: 1.19 (95% CI 0.77–1.84)
Isolated diastolic hypertension defined by the 2017 ACC/AHA guidelines is not consistently associated with increased cardiovascular risk, suggesting lifestyle modification rather than drug therapy may be sufficient.
Jacobsen et al. (2021) conducted a meta-analysis in Isolated diastolic hypertension (n=10,037,843). Isolated diastolic hypertension (2017 ACC/AHA criteria) vs. Non-isolated diastolic hypertension was evaluated on Incident cardiovascular disease (CVD) (HR 1.19, 95% CI 0.77-1.84). Isolated diastolic hypertension was not significantly associated with incident cardiovascular disease over 13 years in MESA (HR 1.19; 95% CI 0.77-1.84) or consistently in a meta-analysis of 8 cohorts.
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