Age and sex specific target of blood pressure for the prevention of cardiovascular event among the treatment naive hypertensive patients

Abstract The time at which hypertension treatment should be initiated for different age groups and sexes remains controversial. We aimed to determine whether the association between blood pressure (BP) and major adverse cardiovascular events (MACE) varies with age and sex. This study enrolled 327,32...

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Autores principales:	Hyoungnae Kim, Seulbi Lee, Eunhee Ha, Soon Hyo Kwon, Jin Seok Jeon, Hyunjin Noh, Dong Cheol Han, Hyung Jung Oh, Dong-Ryeol Ryu
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2020
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/929b156f71964794b79be046840fedae
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spelling	oai:doaj.org-article:929b156f71964794b79be046840fedae2021-12-02T15:11:52ZAge and sex specific target of blood pressure for the prevention of cardiovascular event among the treatment naive hypertensive patients10.1038/s41598-020-78641-32045-2322https://doaj.org/article/929b156f71964794b79be046840fedae2020-12-01T00:00:00Zhttps://doi.org/10.1038/s41598-020-78641-3https://doaj.org/toc/2045-2322Abstract The time at which hypertension treatment should be initiated for different age groups and sexes remains controversial. We aimed to determine whether the association between blood pressure (BP) and major adverse cardiovascular events (MACE) varies with age and sex. This study enrolled 327,328 subjects who had not taken antihypertensive medication in the Korean National Health Service-National Health Screening Cohort between 2002 and 2003. Participants were categorized into four groups according to 2017 American College of Cardiology/American Heart Association hypertension guideline. Primary outcome was MACE characterized by cardiovascular mortality, myocardial infarction, unstable angina, and stroke. During a 10-year follow-up, a significant increase in MACE risk was observed from the stage 1 hypertension group (hazard ratio [HR], 1.23; 95% CI 1.15–1.32; P < 0.001) in time-varying Cox analysis. This relationship was persistent in subjects aged < 70 years, but increased MACE risk was observed only in the stage 2 hypertension group in ≥ 70 years (HR, 1.52; 95% CI 1.32–1.76, P < 0.001). When categorized as per sex, both men and women showed significant MACE risk from stage 1 hypertension. However, on comparing the sexes after stratifying by age, a significantly increased risk of MACE was shown from stage 1 hypertension in men aged < 50 years, but from stage 2 hypertension in men aged ≥ 50 years. Meanwhile, increased MACE risk was observed from stage 2 hypertension in women aged < 60 years, but from stage 1 hypertension in women aged ≥ 60 years. Thus, young male subjects had higher MACE risk than young female subjects, but this difference gradually decreased with age and there was no difference between sexes in subjects aged ≥ 70 years. Therefore, our results suggest that hypertension treatment initiation may need to be individualized depending on age and sex.Hyoungnae KimSeulbi LeeEunhee HaSoon Hyo KwonJin Seok JeonHyunjin NohDong Cheol HanHyung Jung OhDong-Ryeol RyuNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 10, Iss 1, Pp 1-9 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Hyoungnae Kim Seulbi Lee Eunhee Ha Soon Hyo Kwon Jin Seok Jeon Hyunjin Noh Dong Cheol Han Hyung Jung Oh Dong-Ryeol Ryu Age and sex specific target of blood pressure for the prevention of cardiovascular event among the treatment naive hypertensive patients
description	Abstract The time at which hypertension treatment should be initiated for different age groups and sexes remains controversial. We aimed to determine whether the association between blood pressure (BP) and major adverse cardiovascular events (MACE) varies with age and sex. This study enrolled 327,328 subjects who had not taken antihypertensive medication in the Korean National Health Service-National Health Screening Cohort between 2002 and 2003. Participants were categorized into four groups according to 2017 American College of Cardiology/American Heart Association hypertension guideline. Primary outcome was MACE characterized by cardiovascular mortality, myocardial infarction, unstable angina, and stroke. During a 10-year follow-up, a significant increase in MACE risk was observed from the stage 1 hypertension group (hazard ratio [HR], 1.23; 95% CI 1.15–1.32; P < 0.001) in time-varying Cox analysis. This relationship was persistent in subjects aged < 70 years, but increased MACE risk was observed only in the stage 2 hypertension group in ≥ 70 years (HR, 1.52; 95% CI 1.32–1.76, P < 0.001). When categorized as per sex, both men and women showed significant MACE risk from stage 1 hypertension. However, on comparing the sexes after stratifying by age, a significantly increased risk of MACE was shown from stage 1 hypertension in men aged < 50 years, but from stage 2 hypertension in men aged ≥ 50 years. Meanwhile, increased MACE risk was observed from stage 2 hypertension in women aged < 60 years, but from stage 1 hypertension in women aged ≥ 60 years. Thus, young male subjects had higher MACE risk than young female subjects, but this difference gradually decreased with age and there was no difference between sexes in subjects aged ≥ 70 years. Therefore, our results suggest that hypertension treatment initiation may need to be individualized depending on age and sex.
format	article
author	Hyoungnae Kim Seulbi Lee Eunhee Ha Soon Hyo Kwon Jin Seok Jeon Hyunjin Noh Dong Cheol Han Hyung Jung Oh Dong-Ryeol Ryu
author_facet	Hyoungnae Kim Seulbi Lee Eunhee Ha Soon Hyo Kwon Jin Seok Jeon Hyunjin Noh Dong Cheol Han Hyung Jung Oh Dong-Ryeol Ryu
author_sort	Hyoungnae Kim
title	Age and sex specific target of blood pressure for the prevention of cardiovascular event among the treatment naive hypertensive patients
title_short	Age and sex specific target of blood pressure for the prevention of cardiovascular event among the treatment naive hypertensive patients
title_full	Age and sex specific target of blood pressure for the prevention of cardiovascular event among the treatment naive hypertensive patients
title_fullStr	Age and sex specific target of blood pressure for the prevention of cardiovascular event among the treatment naive hypertensive patients
title_full_unstemmed	Age and sex specific target of blood pressure for the prevention of cardiovascular event among the treatment naive hypertensive patients
title_sort	age and sex specific target of blood pressure for the prevention of cardiovascular event among the treatment naive hypertensive patients
publisher	Nature Portfolio
publishDate	2020
url	https://doaj.org/article/929b156f71964794b79be046840fedae
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Age and sex specific target of blood pressure for the prevention of cardiovascular event among the treatment naive hypertensive patients

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