Association of “Elevated Blood Pressure” and “Stage 1 Hypertension” With Cardiovascular Mortality Among an Asian Population

Data on the prevalence of Hypertension (HTN) among elderly Asians is limited. We investigated the prevalence of elevated blood pressure (EBP) and its risk factors in a multiracial Southeast Asian elderly population who participated in the National Kidney Foundation Singapore nationwide screening programme. Among 19,848 subjects ≥ 65 years (approximately 6% of the total Singapore population), the mean age was 70.6 ± 5.26 yrs. After excluding 36.6% with known HTN, analysis revealed that 5,889 (46.8%) of the remaining population had previously undetected EBP >140/ 90. Increasing age, male gender, BMI ≥ 23 kg/m2 and pre-existing diabetes were significantly associated with previously undetected EBP on multivariate analysis. 6% of cases with undetected EBP had proteinuria suggestive of longstanding EBP and renal damage. We conclude that there is a high prevalence of undetected EBP in elderly Asians, suggesting the need for increased e forts in screening in the elderly population. Asia Pac J Public Health 2007; 19(2): 3—9.

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Characteristics of US adults who would be recommended for lifestyle modification without antihypertensive medication to manage blood pressure

American Journal of Hypertension ◽

10.1093/ajh/hpaa173 ◽

2020 ◽

Author(s):

Sandra L Jackson ◽

Soyoun Park ◽

Fleetwood Loustalot ◽

Angela M Thompson-Paul ◽

Yuling Hong ◽

...

Keyword(s):

Blood Pressure ◽

Lifestyle Modification ◽

Sodium Intake ◽

Heart Association ◽

Lifestyle Changes ◽

Elevated Blood Pressure ◽

Elevated Blood ◽

Cvd Risk ◽

Cross Sectional ◽

Stage 1

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.

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2017 ACC/AHA blood pressure classification and incident peripheral artery disease: The Atherosclerosis Risk in Communities (ARIC) Study

European Journal of Preventive Cardiology ◽

10.1177/2047487319865378 ◽

2019 ◽

Vol 27 (1) ◽

pp. 51-59 ◽

Cited By ~ 1

Author(s):

Yifei Lu ◽

Shoshana H Ballew ◽

Hirofumi Tanaka ◽

Moyses Szklo ◽

Gerardo Heiss ◽

...

Keyword(s):

Blood Pressure ◽

Systolic Blood Pressure ◽

Diastolic Blood Pressure ◽

Peripheral Artery Disease ◽

Cox Regression ◽

Elevated Blood Pressure ◽

Elevated Blood ◽

Peripheral Artery ◽

Artery Disease ◽

Stage 1

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.

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