Blood pressure and cardiovascular disease: are diastolic values 80–89 mmHg enough to define hypertension?

Antonio Coca
2020 European Heart Journal  
This editorial refers to 'Coronary artery calcium and cardiovascular disease among adults with isolated diastolic hypertension by the 2017 ACC/AHA guideline: a cohort study and meta-analysis', by A.P. Jacobsen et al., doi:10.1093/ eurheartj/ehab111. Studies with research-grade BP measurements Study Hazard ratio with 95% CI Weight (%) ARIC NHANES CLUE 2 UK BIOBANK MESA Kailuan 0.94 [0.78 -1.13] 7.17 1.12 [0.81 -1.55] 2.72 0.99 [0.88 -1.11] 12.68 1.08 [0.98 -1.19] 15.72 1.19 [0.77 -1.84] 1.58
more » ... .77 -1.84] 1.58 1.05 [0.94 -1.17] 13.64 Studies with routine office BP measurements KNHIS JMDC 1.12 [1.05 -1.19] 20.50 1.17 [1.14 -1.20] 26.00 1.09 [1.03 -1.15] All studies 0.50 1.00 2.00 Graphical abstract Simplified view of the meta-analysis of the association between isolated diastolic hypertension by the 2017 ACC/AHA definition and cardiovascular disease events in epidemiological studies published to date including >10 million participants. Studies with research-grade measurement of blood pressure (BP) highlighted in red show no association, and only studies in which office BP measurements were obtained by routine clinical care showed a modest association (highlighted in green). CI, confidence interval.
doi:10.1093/eurheartj/ehab109 pmid:33677481 fatcat:huechj2kzfaptpxiyflsdpxdmq