Isolated Diastolic Hypertension in the IDACO Study: An Age-Stratified Analysis Using 24-Hour Ambulatory Blood Pressure Measurements
Key result
Isolated diastolic hypertension was not significantly associated with death (HR 0.95; 95% CI 0.79-1.13) or cardiovascular events overall, but increased cardiovascular risk in adults <50 years old.
Why the study?
The prognostic implications of isolated diastolic hypertension defined by 2017 ACC/AHA guidelines had not been evaluated using ambulatory blood pressure monitoring thresholds.
Does isolated diastolic hypertension defined by 2017 ACC/AHA criteria increase the risk of death or cardiovascular events compared to normotension?
Population
11 135 participants in the IDACO database
Comparison
Isolated diastolic hypertension vs normotension
Design
Cohort study
Follow-up
Median of 13.8 years
Authors
Discussion
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Member takes
Implication
Ambulatory IDH thresholds require outcome validation before guiding care; leaves open their added prognostic value beyond office BP.
Study Design
Type
Cohort (n=11,135)
Multicenter
Yes
Structured PICO
Does isolated diastolic hypertension defined by 2017 ACC/AHA criteria increase the risk of death or cardiovascular events compared to normotension?
P
Population
11,135 participants from the IDACO database (median age 54.7 years, 49% female) followed for a median of 13.8 years.
E
Exposure
Isolated diastolic hypertension (IDH) defined by 2017 ACC/AHA guidelines using 24-hour ambulatory blood pressure monitor thresholds (mean systolic BP <125 mm Hg and diastolic BP ≥75 mm Hg)
C
Comparator
Normotension
O
Outcome
Death or cardiovascular eventshard clinical
Main Result
Hazard Ratio: 0.95 (95% CI 0.79–1.13)
Isolated diastolic hypertension defined by 2017 ACC/AHA criteria is a risk factor for cardiovascular events in adults under 50, but not in those 50 years or older.
Cite This Study
McEvoy et al. (2021) conducted a cohort in isolated diastolic hypertension (n=11,135). Isolated diastolic hypertension (IDH) vs. normotension was evaluated on death (HR 0.95, 95% CI 0.79-1.13). Isolated diastolic hypertension was not significantly associated with death (HR 0.95; 95% CI 0.79-1.13) or cardiovascular events overall, but increased cardiovascular risk in adults <50 years old.