Stage 1 hypertension was associated with a higher risk of acute coronary syndromes in women (HR 2.18; 95% CI 1.32-3.60) but not in men (HR 1.30; 95% CI 0.98-1.71) over 16 years of follow-up.
Cohort (n=12,329)
Does stage 1 hypertension increase the risk of acute coronary syndromes in midlife men and women?
Stage 1 hypertension in early 40s is a stronger risk factor for acute coronary syndromes during midlife in women than in men, particularly driven by diastolic hypertension.
Hazard Ratio: 2.18 (95% CI 1.32–3.6)
AIMS: Hypertension has been suggested as a stronger risk factor for acute coronary syndromes (ACS) in women than men. Whether this also applies to stage 1 hypertension blood pressure (BP) 130-139/80-89 mmHg is not known. METHODS AND RESULTS: We tested associations of stage 1 hypertension with ACS in 12 329 participants in the Hordaland Health Study (mean baseline age 41 years, 52% women). Participants were grouped by baseline BP category: Normotension (BP < 130/80 mmHg), stage 1 and stage 2 hypertension (BP ≥140/90 mmHg). ACS was defined as hospitalization or death due to myocardial infarction or unstable angina pectoris during 16 years of follow-up. At baseline, a lower proportion of women than men had stage 1 and 2 hypertension, respectively (25 vs. 35% and 14 vs. 31%, P < 0.001). During follow-up, 1.4% of women and 5.7% of men experienced incident ACS (P < 0.001). Adjusted for diabetes, smoking, body mass index, cholesterol, and physical activity, stage 1 hypertension was associated with higher risk of ACS in women hazard ratio (HR) 2.18, 95% confidence interval (CI) 1.32-3.60, while the association was non-significant in men (HR 1.30, 95% CI 0.98-1.71). After additional adjustment for systolic and diastolic BP, respectively, stage 1 diastolic hypertension was associated with ACS in women (HR 2.79 95% CI 1.62-4.82), but not in men (HR 1.24 95% CI 0.95-1.62), while stage 1 systolic hypertension was not associated with ACS in either sex. CONCLUSION: Among subjects in their early 40s, stage 1 hypertension was a stronger risk factor for ACS during midlife in women than in men.
Kringeland et al. (Mon,) conducted a cohort in acute coronary syndromes (n=12,329). Stage 1 hypertension vs. Normotension was evaluated on hospitalization or death due to myocardial infarction or unstable angina pectoris (HR 2.18, 95% CI 1.32-3.60). Stage 1 hypertension was associated with a higher risk of acute coronary syndromes in women (HR 2.18; 95% CI 1.32-3.60) but not in men (HR 1.30; 95% CI 0.98-1.71) over 16 years of follow-up.