Isolated diastolic hypertension not associated with increased risk of CVD

Reference

McEvoy JW, Daya N, Rahman F, et al. Association of isolated diastolic hypertension as defined by the 2017 ACC/AHA blood pressure guideline with incident cardiovascular outcomes. JAMA 2020;323(4):329-338.

Synopsis

These investigators analyzed data from multiple prospective observational cohort studies, including the National Health and Nutrition Examination Survey (n = 9590) and the Atherosclerosis Risk in Communities, a study of 15,792 adults representing white and black participants living in rural, suburban, and urban areas from 4 US communities. IDH was defined by 2017 ACC/AHA criteria as a systolic blood pressure of less than 130 mg Hg with a diastolic pressure greater than or equal to 80 mm Hg, and by JNC7 criteria as a systolic pressure less than 140 mm Hg with a diastolic pressure greater than or equal to 90 mm Hg. All outcomes were adjudicated by an outcomes committee using information from hospital discharge and death records. Follow-up occurred for a median of 25.2 years. The overall prevalence of IDH was 1.3% using the JNC7 definition and 6.5% using the 2017 ACC/AHA definition. Compared with normotensive individuals, there were no statistically significant associations of IDH by either definition with an increased risk of cardiovascular disease, congestive heart failure, chronic kidney disease, cardiovascular mortality, or all-cause mortality.