New BP Treatment Cutoffs May Not Yield Survival Benefit
Survival benefit not seen with Stage 1 hypertension, only high-risk Stage 2 hypertension
THURSDAY, Dec. 27, 2018 (HealthDay News) -- New blood pressure treatment recommendations may not improve survival from cardiovascular disease (CVD), according to a study recently published in the European Heart Journal.
Seryan Atasoy, from the Ludwig-Maximilians-Universitüt München, and colleagues used data from 11,603 participants (52 percent men; mean age, 47.6 years) in the MONICA/KORA prospective study. The authors sought to evaluate the prevalence of hypertension and associated CVD events.
They found that implementation of the new Stage 1 cutoff (130 to 139 mm Hg systolic or 80 to 89 mm Hg diastolic) increased the prevalence of hypertension from 34 to 63 percent. Only 24 percent of Stage 2 hypertension patients (≥140/90 mm Hg) were receiving treatment. During 10 years of follow-up, there were 370 fatal CVD events. The adjusted CVD-specific mortality rate per 1,000 persons was 1.61 (95 percent confidence interval, 1.10 to 2.25) and 1.07 (percent confidence interval, 0.71 to 1.64) in Stage 2 hypertension and Stage 1 hypertension cases, respectively, compared with those with normal blood pressure. The association of Stage 2 hypertension and CVD mortality was significant in Cox proportional regression models (1.54; 95 percent confidence interval, 1.04 to 2.28; P = 0.03), while the association was not significant for Stage 1 hypertension (0.93; 95 percent confidence interval, 0.61 to 1.44; P = 0.76).
"The lower BP cutoff substantially increased hypertension prevalence, while capturing a population with lower CVD mortality," the authors write.