Relationship of the Blood Pressure Categories, as Defined by the ACC/AHA 2017 Blood Pressure Guidelines, and the Risk of  Development of Cardiovascular Disease in Low-Risk Young  Adults

Insights From a Retrospective Cohort of Young Adults

Seolhye Kim, Yoosoo Chang, Jeonggyu Kang, Ara Cho, Juhee Cho, Yun Soo Hong, Di Zhao, Jiin Ahn, Hocheol Shin, Eliseo Guallar, Seungho Ryu, Ki Chul Sung

Research output: Contribution to journalArticle

Abstract

Background There are limited outcome studies of hypertension among young adults, especially using the new blood pressure ( BP ) categories from the American College of Cardiology and the American Heart Association. We examined associations between the new BP categories and the risk of incident cardiovascular disease ( CVD ) in low-risk and young adults. Methods and Results A cohort study was performed in 244 837 Korean adults (mean age, 39.0 years; SD , 8.9 years) who underwent a comprehensive health examination at Kangbuk Samsung Hospital from January 1, 2011, to December 31, 2016; they were followed up for incident CVD via linkage to the Health Insurance and Review Agency database until the end of 2016, with a median follow-up of 4.3 years. BP was categorized according to the new American College of Cardiology/American Heart Association (ACC/AHA) hypertension guidelines. During 924 420.7 person-years, 1435 participants developed new-onset  CVD (incidence rate of 16.0 per 104 person-years). The multivariable-adjusted hazard ratios (95% CI s ) for CVD comparing elevated BP , stage 1 hypertension, stage 2 hypertension, treated and strictly controlled (systolic BP /diastolic BP <130/80 mm Hg with antihypertensive use), treated and controlled (systolic BP 130-139 and diastolic BP 80 to 89 mm Hg with antihypertensive use), treated uncontrolled, and untreated hypertension to normal BP were 1.37 (1.11-1.68), 1.45 (1.26-1.68), 2.12 (1.74-2.58), 1.41 (1.12-1.78), 1.97 (1.52-2.56), 2.29 (1.56-3.37) and 1.93 (1.53-2.45), respectively. Conclusions In this large cohort of low-risk and young adults, all categories of higher BP were independently associated with an increased risk of CVD compared with normal BP , underscoring the importance of BP management even in these low-risk populations.

Original languageEnglish (US)
Pages (from-to)e011946
JournalJournal of the American Heart Association
Volume8
Issue number11
DOIs
StatePublished - Jun 4 2019

Fingerprint

Cardiovascular Diseases
Guidelines
Blood Pressure
Hypertension
Young Adult
Antihypertensive Agents
Health Insurance
Cohort Studies
Outcome Assessment (Health Care)
Databases

Keywords

  • cardiovascular outcomes
  • cohort study
  • high blood pressure
  • hypertension
  • incidence
  • risk factor

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Relationship of the Blood Pressure Categories, as Defined by the ACC/AHA 2017 Blood Pressure Guidelines, and the Risk of  Development of Cardiovascular Disease in Low-Risk Young  Adults : Insights From a Retrospective Cohort of Young Adults. / Kim, Seolhye; Chang, Yoosoo; Kang, Jeonggyu; Cho, Ara; Cho, Juhee; Hong, Yun Soo; Zhao, Di; Ahn, Jiin; Shin, Hocheol; Guallar, Eliseo; Ryu, Seungho; Sung, Ki Chul.

In: Journal of the American Heart Association, Vol. 8, No. 11, 04.06.2019, p. e011946.

Research output: Contribution to journalArticle

@article{61270bfd5fe64807a3fcffd23944f062,
title = "Relationship of the Blood Pressure Categories, as Defined by the ACC/AHA 2017 Blood Pressure Guidelines, and the Risk of  Development of Cardiovascular Disease in Low-Risk Young  Adults: Insights From a Retrospective Cohort of Young Adults",
abstract = "Background There are limited outcome studies of hypertension among young adults, especially using the new blood pressure ( BP ) categories from the American College of Cardiology and the American Heart Association. We examined associations between the new BP categories and the risk of incident cardiovascular disease ( CVD ) in low-risk and young adults. Methods and Results A cohort study was performed in 244 837 Korean adults (mean age, 39.0 years; SD , 8.9 years) who underwent a comprehensive health examination at Kangbuk Samsung Hospital from January 1, 2011, to December 31, 2016; they were followed up for incident CVD via linkage to the Health Insurance and Review Agency database until the end of 2016, with a median follow-up of 4.3 years. BP was categorized according to the new American College of Cardiology/American Heart Association (ACC/AHA) hypertension guidelines. During 924 420.7 person-years, 1435 participants developed new-onset  CVD (incidence rate of 16.0 per 104 person-years). The multivariable-adjusted hazard ratios (95{\%} CI s ) for CVD comparing elevated BP , stage 1 hypertension, stage 2 hypertension, treated and strictly controlled (systolic BP /diastolic BP <130/80 mm Hg with antihypertensive use), treated and controlled (systolic BP 130-139 and diastolic BP 80 to 89 mm Hg with antihypertensive use), treated uncontrolled, and untreated hypertension to normal BP were 1.37 (1.11-1.68), 1.45 (1.26-1.68), 2.12 (1.74-2.58), 1.41 (1.12-1.78), 1.97 (1.52-2.56), 2.29 (1.56-3.37) and 1.93 (1.53-2.45), respectively. Conclusions In this large cohort of low-risk and young adults, all categories of higher BP were independently associated with an increased risk of CVD compared with normal BP , underscoring the importance of BP management even in these low-risk populations.",
keywords = "cardiovascular outcomes, cohort study, high blood pressure, hypertension, incidence, risk factor",
author = "Seolhye Kim and Yoosoo Chang and Jeonggyu Kang and Ara Cho and Juhee Cho and Hong, {Yun Soo} and Di Zhao and Jiin Ahn and Hocheol Shin and Eliseo Guallar and Seungho Ryu and Sung, {Ki Chul}",
year = "2019",
month = "6",
day = "4",
doi = "10.1161/JAHA.119.011946",
language = "English (US)",
volume = "8",
pages = "e011946",
journal = "Journal of the American Heart Association",
issn = "2047-9980",
publisher = "Wiley-Blackwell",
number = "11",

}

TY - JOUR

T1 - Relationship of the Blood Pressure Categories, as Defined by the ACC/AHA 2017 Blood Pressure Guidelines, and the Risk of  Development of Cardiovascular Disease in Low-Risk Young  Adults

T2 - Insights From a Retrospective Cohort of Young Adults

AU - Kim, Seolhye

AU - Chang, Yoosoo

AU - Kang, Jeonggyu

AU - Cho, Ara

AU - Cho, Juhee

AU - Hong, Yun Soo

AU - Zhao, Di

AU - Ahn, Jiin

AU - Shin, Hocheol

AU - Guallar, Eliseo

AU - Ryu, Seungho

AU - Sung, Ki Chul

PY - 2019/6/4

Y1 - 2019/6/4

N2 - Background There are limited outcome studies of hypertension among young adults, especially using the new blood pressure ( BP ) categories from the American College of Cardiology and the American Heart Association. We examined associations between the new BP categories and the risk of incident cardiovascular disease ( CVD ) in low-risk and young adults. Methods and Results A cohort study was performed in 244 837 Korean adults (mean age, 39.0 years; SD , 8.9 years) who underwent a comprehensive health examination at Kangbuk Samsung Hospital from January 1, 2011, to December 31, 2016; they were followed up for incident CVD via linkage to the Health Insurance and Review Agency database until the end of 2016, with a median follow-up of 4.3 years. BP was categorized according to the new American College of Cardiology/American Heart Association (ACC/AHA) hypertension guidelines. During 924 420.7 person-years, 1435 participants developed new-onset  CVD (incidence rate of 16.0 per 104 person-years). The multivariable-adjusted hazard ratios (95% CI s ) for CVD comparing elevated BP , stage 1 hypertension, stage 2 hypertension, treated and strictly controlled (systolic BP /diastolic BP <130/80 mm Hg with antihypertensive use), treated and controlled (systolic BP 130-139 and diastolic BP 80 to 89 mm Hg with antihypertensive use), treated uncontrolled, and untreated hypertension to normal BP were 1.37 (1.11-1.68), 1.45 (1.26-1.68), 2.12 (1.74-2.58), 1.41 (1.12-1.78), 1.97 (1.52-2.56), 2.29 (1.56-3.37) and 1.93 (1.53-2.45), respectively. Conclusions In this large cohort of low-risk and young adults, all categories of higher BP were independently associated with an increased risk of CVD compared with normal BP , underscoring the importance of BP management even in these low-risk populations.

AB - Background There are limited outcome studies of hypertension among young adults, especially using the new blood pressure ( BP ) categories from the American College of Cardiology and the American Heart Association. We examined associations between the new BP categories and the risk of incident cardiovascular disease ( CVD ) in low-risk and young adults. Methods and Results A cohort study was performed in 244 837 Korean adults (mean age, 39.0 years; SD , 8.9 years) who underwent a comprehensive health examination at Kangbuk Samsung Hospital from January 1, 2011, to December 31, 2016; they were followed up for incident CVD via linkage to the Health Insurance and Review Agency database until the end of 2016, with a median follow-up of 4.3 years. BP was categorized according to the new American College of Cardiology/American Heart Association (ACC/AHA) hypertension guidelines. During 924 420.7 person-years, 1435 participants developed new-onset  CVD (incidence rate of 16.0 per 104 person-years). The multivariable-adjusted hazard ratios (95% CI s ) for CVD comparing elevated BP , stage 1 hypertension, stage 2 hypertension, treated and strictly controlled (systolic BP /diastolic BP <130/80 mm Hg with antihypertensive use), treated and controlled (systolic BP 130-139 and diastolic BP 80 to 89 mm Hg with antihypertensive use), treated uncontrolled, and untreated hypertension to normal BP were 1.37 (1.11-1.68), 1.45 (1.26-1.68), 2.12 (1.74-2.58), 1.41 (1.12-1.78), 1.97 (1.52-2.56), 2.29 (1.56-3.37) and 1.93 (1.53-2.45), respectively. Conclusions In this large cohort of low-risk and young adults, all categories of higher BP were independently associated with an increased risk of CVD compared with normal BP , underscoring the importance of BP management even in these low-risk populations.

KW - cardiovascular outcomes

KW - cohort study

KW - high blood pressure

KW - hypertension

KW - incidence

KW - risk factor

UR - http://www.scopus.com/inward/record.url?scp=85067296527&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85067296527&partnerID=8YFLogxK

U2 - 10.1161/JAHA.119.011946

DO - 10.1161/JAHA.119.011946

M3 - Article

VL - 8

SP - e011946

JO - Journal of the American Heart Association

JF - Journal of the American Heart Association

SN - 2047-9980

IS - 11

ER -