title: Hypertension phenotypes and incident cardiovascular disease and mortality events in a decade follow-up of a Middle East cohort.
abstract: OBJECTIVE
  To investigate the association of hypertension phenotypes, with the risk of cardiovascular disease (CVD) and mortality.
  
  
  METHODS
  We examined the risk of hypertension phenotypes, that is, isolated systolic hypertension (ISH), isolated diastolic hypertension (IDH), systolic-diastolic hypertension (SDH), controlled blood pressure (CBP), and uncontrolled blood pressure (UBP) among 6974 middle-aged and 882 elderly participants. Cox regression analysis was used to estimate the hazard ratio for hypertension phenotypes, considering those with normotension as the reference.
  
  
  RESULTS
  During more than 10 years of follow-up, in the middle-aged group, 490 CVD events and 152 deaths occurred; corresponding rates for the elderly group were 194 and 183, respectively. In middle-aged patients, ISH, SDH, and UBP increased the risk of CVD, whereas UBP increased the risk of mortality due to CVD and any cause (hazard ratio 5.67 and 2.95, respectively) and IDH increased only the risk of total mortality in the middle-aged group (hazard ratio 2.01; all P values <0.05). In elderly patients, ISH, SDH, and UBP significantly increased the risks of CVD. IDH (hazard ratio 3.20 and 2.01), SDH (hazard ratio 3.80 and 3.23) and CBP (hazard ratio 2.86 and 1.87) increased the risks of CVD and all-cause mortality in this group, respectively (all P values <0.05).
  
  
  CONCLUSIONS
  In both middle-aged and elderly population, ISH, SDH, and UBP increase the risk of CVD. Controlling of BP to less than 140/90 mmHg decreases the risk of mortality events among the middle-aged population; however, it is not suitable for the elderly as it was associated with higher risk of mortality.
authors.affiliation: aPrevention of Metabolic Disorders Research Center bEndocrine Research Center, Research Institute for Endocrine Sciences (RIES), Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran.
authors.forename: Mojtaba
authors.initials: M
authors.lastname: Lotfaliany
authors.forename: Samaneh
authors.initials: S
authors.lastname: Akbarpour
authors.forename: Amirhossein
authors.initials: A
authors.lastname: Mozafary
authors.forename: Reyhaneh Rajab
authors.initials: RR
authors.lastname: Boloukat
authors.forename: Fereidoun
authors.initials: F
authors.lastname: Azizi
authors.forename: Farzad
authors.initials: F
authors.lastname: Hadaegh
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000401:mortality; D002423:Cause of Death; D003971:Diastole; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000235:genetics / Q000503:physiopathology; D015994:Incidence; D007492:Iran / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010641:Phenotype; D015995:Prevalence; D012044:Regression Analysis; D012307:Risk Factors; D013599:Systole