Division of Cardiology, Department of Internal Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul.
Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital.
J Hypertens. 2022 Dec 1;40(12):2449-2458. doi: 10.1097/HJH.0000000000003277. Epub 2022 Aug 18.
It is unclear what thresholds and targets of office blood pressure (BP) for treatment are appropriate in younger (<50 years old) hypertensive patients. Thus, the aim of this study was to evaluate associations of office BP levels with major cardiovascular events (MACEs) in these patients.
Using the Korean National Health Insurance Service database, data of 98 192 younger (<50 years old) hypertensive patients having BP measurements available without any history of cardiovascular events from 2002 to 2011 were extracted. This cohort study evaluated associations of BP levels (<120/<70, 120-129/70-79, 130-139/80-89, 140-149/90-99, and ≥150/≥100 mmHg) with MACEs. The study outcome was MACE, a composite of cardiovascular death, myocardial infarction, stroke, and heart failure.
In all patients, those treated with antihypertensive medication accounted for 34.7% and those who achieved BP less than 130/80 mmHg accounted for 35.5%. During a mean follow-up of 9.5 ± 2.8 years, 4918 (5%) MACEs were documented in our cohort. The risk of MACE was the lowest [adjusted hazard ratio: 0.77, 95% confidence interval (CI) 0.66-0.89] for those with BP level of less than 120/less than 70 mmHg. It was the highest (hazard ratio 2.0, 95% CI 1.83-2.19) for those with BP level of at least 150/at least 100 mmHg in comparison with those with BP level of 130-139/80-89 mmHg. These results were consistent for all age groups (20-29, 30-39, and 40-49 years) and both sexes.
Elevated BP level from less than 120 mmHg/less than 70 mmHg is significantly correlated with an increased risk of MACE in younger (<50 years old) Korean hypertensive patients. Lowering BP to less than 120 mmHg/less than 70 mmHg is needed for these patients.
目前尚不清楚对于年轻（<50 岁）高血压患者，用于治疗的诊室血压（BP）的阈值和目标值是多少。因此，本研究旨在评估这些患者的诊室 BP 水平与主要心血管事件（MACE）之间的相关性。
本研究使用韩国国家健康保险服务数据库，提取了 2002 年至 2011 年间无心血管事件史且可测量 BP 的 98192 名年轻（<50 岁）高血压患者的数据。这项队列研究评估了 BP 水平（<120/<70、120-129/70-79、130-139/80-89、140-149/90-99 和≥150/≥100mmHg）与 MACE 之间的相关性。研究结局是 MACE，包括心血管死亡、心肌梗死、卒中和心力衰竭的综合指标。
在所有患者中，接受降压药物治疗的患者占 34.7%，血压低于 130/80mmHg 的患者占 35.5%。在平均 9.5±2.8 年的随访期间，我们的队列中记录了 4918 例（5%）MACE。BP 水平<120/<70mmHg 的患者发生 MACE 的风险最低（调整后的 HR：0.77，95%CI：0.66-0.89）。与 BP 水平 130-139/80-89mmHg 的患者相比，BP 水平≥150/≥100mmHg 的患者的风险最高（HR：2.0，95%CI：1.83-2.19）。这些结果在所有年龄组（20-29、30-39 和 40-49 岁）和男女两性中均一致。
年轻（<50 岁）韩国高血压患者的 BP 水平从<120mmHg/<70mmHg 升高与 MACE 风险增加显著相关。这些患者需要将 BP 降低至<120mmHg/<70mmHg。
