Compared to normal blood pressure, uncontrolled hypertension was associated with a 33% higher risk of cardiovascular disease in adults aged ≥75 years (HR 1.33).
Does elevated blood pressure status increase the risk of incident cardiovascular disease in adults aged ≥75 years without prior cardiovascular events?
In adults aged 75 and older without prior cardiovascular disease, elevated blood pressure categories, particularly uncontrolled hypertension, are significantly associated with an increased risk of stroke and myocardial infarction.
Absolute Event Rate: 0% vs 0%
Abstract Aims This nationwide observational cohort study examined the association between hypertension status and cardiovascular disease (CVD) risk in adults aged ≥75 years without prior CVD events. Methods Using the Korean National Health Insurance Service (K-NHIS) database, we included individuals aged ≥75 years who underwent health check-ups in 2012–2015. Five statuses of hypertension were defined—normal, pre-hypertension, new-onset hypertension, well-controlled hypertension, and uncontrolled hypertension. The primary outcome was incident CVD (stroke or myocardial infarction). Subdistribution hazard ratios (HRs) were estimated using Fine–Gray models with death as a competing risk. Penalized splines evaluated nonlinear associations of systolic and diastolic blood pressure with outcomes. Results Among 869,781 participants (mean age 78.49 ± 3.48 years; 41.7% men), 120,353 (13.8%) developed CVD during a mean follow-up of 6.67 years. Compared with normal, pre-hypertension (HR 1.13; 95% CI 1.11–1.16), new-onset hypertension (HR 1.29; 95% CI 1.26–1.33), controlled hypertension (HR 1.21; 95% CI 1.18–1.23), and uncontrolled hypertension (HR 1.33; 95% CI 1.30–1.36) were all associated with higher CVD risk. Similar associative patterns were observed for stroke and myocardial infarction. Conclusion In this large observational cohort, elevated blood pressure (BP) categories were associated with higher risks of stroke and myocardial infarction in adults aged ≥75 years, with the highest risk in uncontrolled hypertension. Stroke risk rose progressively with increasing systolic BP, whereas myocardial infarction demonstrated a U-shaped relationship with diastolic BP. These findings highlight clinically relevant risk patterns in late life and may support future research aimed at optimizing BP assessment in older adults.
Choi et al. (Fri,) reported a other. Compared to normal blood pressure, uncontrolled hypertension was associated with a 33% higher risk of cardiovascular disease in adults aged ≥75 years (HR 1.33).
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