An Analysis of the Effects of Blood Pressure and Antihypertensive Drugs on Heart Disease
Health (Irvine, Calif.)
The American College of Cardiology (ACC), American Heart Association (AHA) and other organizations announced a new hypertension guideline (2017 ACA/AHA Guideline) in November 2017. However, other organizations such as the European Society of Cardiology and European Society of Hypertension maintained their diagnostic thresholds. It is necessary to evaluate the effects of blood pressure (BP) and antihypertensive drugs on the probability of having heart disease (HD). Data and Methods: The effects
... thods: The effects of BP, antihypertensive drugs and other factors on the probability of undergoing HD treatment were analyzed. We used a dataset containing 83,287 medical check-up and treatment records obtained from 35,504 individuals in 5 fiscal years. The probit models were used in the study. Considering the possibility of endogeneity problems, different types of models were used. Results: We could not find evidence that a higher systolic BP increased the probability of undergoing HD treatment. However, diastolic BP increased the probability in most of the models. Taking antihypertensive drugs also increased the probability of undergoing HD treatment. Diabetes was another important risk factor. Conclusion: The results of this study did not support the new 2017 ACC/AHA Guideline. It is necessary to choose proper drugs and methods to reduce the risks of side effects. Limitations: The dataset was observatory, the data were obtained from just one medical society, and sample selection bias might exist. Health 159 mmHg; DBP of 90 -99 mmHg) and Stage 2 (SBP of 160 mmHg or over; DBP of 100 mmHg or over). WHO and ISH  classified hypertension into the following three categories: Grade 1 (mild), SBP of 140 -159 mmHg or DBP of 90 -99 mmHg; Grade 2 (moderate), SBP of 160 -179 mmHg or DBP of 100 -109 mmHg; and Grade 3 (severe), SBP of 180 mmHg or over or DBP of 110 mmHg or over. They predicted the probability of serious cardiovascular disease (CVD) in the next 10 years based on BP and other risk factors. The probabilities were 20% -30% and 30% or more in the high-and very-high-risk groups, respectively. ACC/AHA Guideline, the criterion for hypertension is 130/80 mmHg. Furthermore, the 2017 ACC/AHA Guideline changed "prehypertension" to "elevated BP" (SBP of 120 -129 mmHg, DBP below 80 mm Hg) and defined "Stage 1 hypertension" as SBP of 130 -139 mmHg or DBP of 80 -89 mmHg, and "Stage 2 hypertension" as SBP of 140 mmHg or over or DBP of 90 mmHg or over and replaced K. Nawata et al.