Abstract P198: Why is the 10-Year-ASCVD Risk Higher in Elevated Blood Pressure Group Than Stage-1 Hypertension Group Among Korean Population?

Circulation ◽  
2019 ◽  
Vol 139 (Suppl_1) ◽  
Author(s):  
Yongwoo Jeon ◽  
Ho Kyou Lee ◽  
Hyeon Chang Kim
Author(s):  
Victoria R. Greenberg ◽  
Michelle Silasi ◽  
Lisbet S. Lundsberg ◽  
Jennifer F. Culhane ◽  
Uma M. Reddy ◽  
...  

2020 ◽  
Vol 222 (1) ◽  
pp. S92-S93
Author(s):  
Martha Tesfalul ◽  
Jeffrey Sperling ◽  
Cinthia Blat ◽  
Nisha Parikh ◽  
Juan Gonzalez Velez ◽  
...  

Author(s):  
Sandra L Jackson ◽  
Soyoun Park ◽  
Fleetwood Loustalot ◽  
Angela M Thompson-Paul ◽  
Yuling Hong ◽  
...  

Abstract Background The 2017 American College of Cardiology / American Heart Association Guideline for blood pressure (BP) management newly classifies millions of Americans with elevated blood pressure or stage 1 hypertension for recommended lifestyle modification alone (without pharmacotherapy). This study characterized these adults, including their CVD risk factors, barriers to lifestyle modification, and healthcare access. Methods This cross-sectional study examined nationally representative National Health and Nutrition Examination Survey data, 2013-2016, on 10,205 US adults aged ≥18, among whom 2,081 had elevated blood pressure or stage 1 hypertension and met 2017 ACC/AHA BP Guideline criteria for lifestyle modification alone. Results An estimated 22% of US adults (52 million) would be recommended for lifestyle modification alone. Among these, 58% were men, 43% had obesity, 52% had low quality diet, 95% consumed excess sodium, 43% were physically inactive, and 8% consumed excess alcohol. Many reported attempting lifestyle changes (range: 39%-60%). Those who reported receiving health professional advice to lose weight (adjusted prevalence ratio 1.21, 95% confidence interval 1.06-1.38), reduce sodium intake (2.33, 2.00-2.72), or exercise more (1.60, 1.32-1.95) were significantly more likely to report attempting changes. However, potential barriers to lifestyle modification included 28% of adults reporting disability, asthma, or arthritis. Additionally, 20% had no health insurance and 22% had no healthcare visits in the last year. Conclusions One fifth of US adults met 2017 ACC/AHA BP Guideline criteria for lifestyle modification alone, and many reported attempting behavior change. However, barriers exist such as insurance gaps, limited access to care, and physical impairment.


2019 ◽  
Vol 27 (1) ◽  
pp. 51-59 ◽  
Author(s):  
Yifei Lu ◽  
Shoshana H Ballew ◽  
Hirofumi Tanaka ◽  
Moyses Szklo ◽  
Gerardo Heiss ◽  
...  

Aims The aim of this study was to evaluate the associations of blood pressure categorization based on the 2017 American College of Cardiology and American Heart Association guideline with the risk of peripheral artery disease (PAD). Methods Among 13,113 middle-aged participants, we investigated the associations of 2017 blood pressure categories (systolic <120 and diastolic <80 mmHg (normal if no anti-hypertensive medications; reference), 120–129 and <80 (elevated), 130–139 and/or 80–89 (stage 1 hypertension), and ≥140 and/or ≥90 (stage 2 hypertension)) with incident PAD (hospitalizations with a diagnosis or leg revascularization) using Cox regression models. Analyses were separately conducted in individuals with and without anti-hypertensive medications. Results During a median follow-up of 25.4 years, 466 incident PAD occurred (271 cases in 9858 participants without anti-hypertensive medications). In participants without anti-hypertensive medications, we observed significant hazard ratios of PAD in elevated blood pressure (1.80 (1.28–2.51)) and stage 2 hypertension (2.40 (1.72–3.34)), but not in stage 1 hypertension. Analyzing systolic and diastolic blood pressure separately, higher systolic blood pressure categories showed significant associations with incident PAD in a graded fashion whereas, for diastolic blood pressure, only ≥90 mmHg did. Generally similar patterns were seen among participants on anti-hypertensive medication, while they had higher risk of PAD than those without at each blood pressure category. Conclusions Systolic blood pressure, including the category of 130–139 mmHg, showed stronger associations with incident PAD than did diastolic blood pressure. Consequently, elevated blood pressure conferred similar or even greater risk of PAD than stage 1 hypertension, with implications on how to interpret new blood pressure categories in terms of leg vascular health.


2019 ◽  
Vol 33 (4) ◽  
pp. 308-318 ◽  
Author(s):  
Elena Critselis ◽  
◽  
Christina Chrysohoou ◽  
Natasa Kollia ◽  
Ekavi N. Georgousopoulou ◽  
...  

2021 ◽  
Vol 9 ◽  
Author(s):  
Godfred O. Boateng ◽  
Stella T. Lartey ◽  
Philip Baiden ◽  
Lei Si ◽  
Richard Berko Biritwum ◽  
...  

This paper assessed the transition probabilities between the stages of hypertension severity and the length of time an individual might spend at a particular disease state using the new American College of Cardiology/American Heart Association hypertension blood pressure guidelines. Data for this study were drawn from the Ghana WHO SAGE longitudinal study, with an analytical sample of 1884 across two waves. Using a multistate Markov model, we estimated a seven-year transition probability between normal/elevated blood pressure (systolic ≤ 129 mm Hg &amp; diastolic &lt;80 mm Hg), stage 1 (systolic 130-139 mm Hg &amp; diastolic 80-89 mm Hg), and stage 2 (systolic ≥140mm Hg &amp; diastolic≥90 mm Hg) hypertension and adjusted for the individual effects of anthropometric, lifestyle, and socio-demographic factors. At baseline, 22.5% had stage 1 hypertension and 52.2% had stage 2 hypertension. The estimated seven-year transition probability for the general population was 19.0% (95% CI: 16.4, 21.8) from normal/elevated blood pressure to stage 1 hypertension, 31.6% (95% CI: 27.6, 35.4%) from stage 1 hypertension to stage 2 hypertension, and 48.5% (45.6, 52.1%) for remaining at stage 2. Other factors such as being overweight, obese, female, aged 60+ years, urban residence, low education and high income were associated with an increased probability of remaining at stage 2 hypertension. However, consumption of recommended servings of fruits and vegetables per day was associated with a delay in the onset of stage 1 hypertension and a recovery to normal/elevated blood pressure. This is the first study to show estimated transition probabilities between the stages of hypertension severity across the lifespan in sub-Saharan Africa. The results are important for understanding progression through hypertension severity and can be used in simulating cost-effective models to evaluate policies and the burden of future healthcare.


2020 ◽  
Vol 9 (18) ◽  
Author(s):  
Jonathan J. Mayl ◽  
Charles A. German ◽  
Alain G. Bertoni ◽  
Bharathi Upadhya ◽  
Prashant D. Bhave ◽  
...  

Background Heavy alcohol consumption has a well‐established association with hypertension. However, doubt persists whether moderate alcohol consumption has a similar link. This relationship is not well‐studied in patients with diabetes mellitus. We aimed to describe the association of alcohol consumption with prevalent hypertension in participants in the ACCORD (Action to Control Cardiovascular Risk in Diabetes) trial. Methods and Results Alcohol consumption was categorized as none, light (1–7 drinks/week), moderate (8–14 drinks/week), and heavy (≥15 drinks/week). Blood pressure was categorized using American College of Cardiology/American Heart Association guidelines as normal, elevated blood pressure, stage 1 hypertension, and stage 2 hypertension. Multivariable logistic regression was used to explore the association between alcohol consumption and prevalent hypertension. A total of 10 200 eligible participants were analyzed. Light alcohol consumption was not associated with elevated blood pressure or any stage hypertension. Moderate alcohol consumption was associated with elevated blood pressure, stage 1, and stage 2 hypertension (odds ratio [OR], 1.79; 95% CI, 1.04–3.11, P =0.03; OR, 1.66; 95% CI, 1.05–2.60, P =0.03; and OR, 1.62; 95% CI, 1.03–2.54, P =0.03, respectively). Heavy alcohol consumption was associated with elevated blood pressure, stage 1, and stage 2 hypertension (OR, 1.91; 95% CI, 1.17–3.12, P =0.01; OR, 2.49; 95% CI, 1.03–6.17, P =0.03; and OR, 3.04; 95% CI, 1.28–7.22, P =0.01, respectively). Conclusions Despite prior research, our findings show moderate alcohol consumption is associated with hypertension in patients with type 2 diabetes mellitus and elevated cardiovascular risk. We also note a dose‐risk relationship with the amount of alcohol consumed and the degree of hypertension.


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