Risk of cardiovascular disease according to blood pressure categories in an argentinian cohort.
BACKGROUND
Hypertension is a recognized strong risk factor for cardiovascular disease. However, no data was available in our country to quantify the relationship between blood pressure and cardiovascular event.


OBJECTIVE
to quantify the risk of cardiovascular events according to blood pressure categories.


METHODS
A prospective epidemiological study was conducted in 1526 inhabitants from Rauch City, (Buenos Aires, Argentina) between 1997 and 2012. Subjects were classified into one of these blood-pressure categories: 1-optimal, 2-normal, 3-high-normal, 4-grade 1 hypertension, 5-grade 2 hypertension and 6-grade 3 hypertension. The first CVD event, including unstable angina pectoris, fatal and non-fatal myocardial infarction, myocardial revascularization, and fatal or non-fatal stroke, was defined as the primary endpoint. Multivariable Cox proportional-hazards regression models were used to estimate the relative risk (HR) of CVD according to base-line blood-pressure categories.


RESULTS
In 2012, 1124 individuals (73.7% of the baseline sample), 719 women and 405 men (in 1997, aged 45±16 and 46±16 respectively) or their relatives in case of death, could be surveyed again in order to obtain information concerning incident CVD events. Cardiovascular event rates and HR values increased in a stepwise manner across the blood pressure categories (p for trend across categories <0.001 in both sex); however, in subjects aged ≥55 years a j-curve phenomenon was observed, showing the lowest incidence in the high-normal category. In all categories CVD events rates were higher for men.


CONCLUSIONS
This study quantified relationships between BP and CVD starting from high-normal blood pressure in Argentina.
Hospital Universitario Gral. San Martín, La Plata.
Martin R
MR
Salazar
Hospital Universitario Gral. San Martín, La Plata.
Walter G
WG
Espeche
Hospital Municipal, Rauch, Buenos Aires, Argentina.
Marcelo
M
Aizpurua
Hospital Universitario Gral. San Martín, La Plata, Buenos Aires, Argentina.
Betty C
BC
Leiva Sisnieguez
Hospital Universitario Gral. San Martín, La Plata, Buenos Aires, Argentina.
Carlos D
CD
Leiva Sisnieguez
Hospital Universitario Gral. San Martín, La Plata, Buenos Aires, Argentina.
Carlos A
CA
Dulbecco
Facultad de Ciencias Médicas, UNLP, Argentina.
Horacio A
HA
Carbajal
D000293:Adolescent; D000328:Adult; D000368:Aged; D001118:Argentina; D001794:Blood Pressure / Q000502:physiology*; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012720:Severity of Illness Index; D055815:Young Adult