title: The effects of control of systolic and diastolic hypertension on cardiovascular and all-cause mortality in a community-based population cohort.
abstract: The objective of this study (follow-up of 26,113 people) was to investigate differences in the risk of cardiovascular disease (CVD) and all-cause mortality among hypertensive people according to the control of systolic blood pressure (SBP) and diastolic blood pressure (DBP). People with a history of coronary heart disease, heart failure, cancer or incomplete data at baseline (n=1113) were excluded from the study. The participants were classified into six groups according to their blood pressure status. Treated hypertensive individuals with controlled SBP and DBP did not experience an increase in all-cause mortality compared with normotensive people. The increase in all-cause mortality was 1.48-fold (95% confidence interval (CI) 1.09-2.01) among those who were treated with antihypertensive drugs and had only their DBP controlled and 1.45-fold (95% CI 1.04-2.02) among those who were treated and had only their SBP controlled. Treated patients with both SBP and DBP controlled did not have an increased risk of CVD mortality when compared with normotensive people. The risk of CVD mortality was statistically significantly higher in treated hypertensive people with SBP alone, DBP alone or both SBP and DBP uncontrolled. Our study indicates that uncontrolled SBP alone and DBP alone are risk factors of all-cause and CVD mortality.
authors.affiliation: 1] Institute of Clinical Medicine/Internal Medicine, University of Oulu, Oulu, Finland [2] Fundación para la Prevención y Control de las Enfermedades Crónicas No-Transmisibles en América Latina (FunPRECAL), Mar del Plata, Argentina [3] Unit of Non-Communicable Diseases, Department of Prevention and Control, Ministry of Health, Bogotá, Colombia.
authors.forename: N C
authors.initials: NC
authors.lastname: Barengo
authors.forename: R
authors.initials: R
authors.lastname: Antikainen
authors.forename: M
authors.initials: M
authors.lastname: Kastarinen
authors.forename: T
authors.initials: T
authors.lastname: Laatikainen
authors.forename: J
authors.initials: J
authors.lastname: Tuomilehto
mesh_terms: D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects*; D002423:Cause of Death; D003430:Cross-Sectional Studies; D003971:Diastole; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D013599:Systole; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents