In elderly hypertensive patients, a mean achieved diastolic blood pressure of <65 mm Hg was associated with an increased risk of cardiovascular events in females (HR 2.33) but not in males.
Observational (n=8,355)
Open-label
Yes
Do sex differences exist in achieved diastolic blood pressure and its association with cardiovascular outcomes in elderly hypertensive patients?
In elderly hypertensive patients, females achieve lower DBP than males, and a low achieved DBP (<65 mm Hg) is associated with higher CVD risk in females but not males, indicating a sex-specific J-curve relationship.
Effect estimate: HR 2.33 (95% CI 1.01-5.34)
BACKGROUND: Blood pressure profiles differ in males and females. Low diastolic blood pressure (DBP) is associated with increased risk of cardiovascular disease (CVD). However, sex differences in achieved DBP and associated CVD risk remain unclear. OBJECTIVES: The aim of this study was to examine sex differences in achieved DBP and CVD outcomes in elderly hypertensive patients. METHODS: This study is a secondary analysis of the STEP (Strategy of Blood Pressure Intervention in the Elderly Hypertensive Patients) trial. The mean achieved DBP was compared between male and female participants. The association between mean achieved DBP and cardiovascular risk was evaluated as a continuous and categorical variable with a cubic spline model or Cox proportional hazards regression model. RESULTS: A total of 8,355 patients were included in this analysis. Median follow-up time was 3.08 years (Q1-Q3: 2.97-3.25 years). Female patients achieved lower DBP levels than male patients throughout the trial duration (P 81 mm Hg (females: HR: 1.10; 95% CI: 1.03-1.16; males: HR: 1.06; 95% CI: 1.01-1.11). Mean achieved DBP of <65 mm Hg was associated with increased CVD risk only in female patients (females: HR: 2.33; 95% CI: 1.01-5.34; males: HR: 0.87; 95% CI: 0.12-6.25). CONCLUSIONS: This study shows in elderly hypertensive patients, females have lower achieved DBP. A J-shaped relation between achieved DBP and CVD risk was observed in female, but not male patients. Low achieved DBP is associated with higher CVD risk among females but not males.
Ling et al. (Fri,) conducted a observational in Hypertension (n=8,355). Mean achieved diastolic blood pressure <65 mm Hg vs. Mean achieved diastolic blood pressure 71-81 mm Hg was evaluated on Composite of stroke, acute coronary syndrome, acute decompensated heart failure, coronary revascularization, atrial fibrillation, or cardiovascular death (HR 2.33, 95% CI 1.01-5.34). In elderly hypertensive patients, a mean achieved diastolic blood pressure of <65 mm Hg was associated with an increased risk of cardiovascular events in females (HR 2.33) but not in males.