Arafa Ahmed, Kokubo Yoshihiro, Teramoto Masayuki, Kashima Rena, Shimamoto Keiko, Nakao Yoko M, Matsuo Miki, Yoshihara Fumiki, Izumi Chisato
Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, Suita, Japan.
Department of Public Health, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt.
Hypertens Res. 2023 Mar;46(3):575-582. doi: 10.1038/s41440-022-01128-3. Epub 2023 Jan 6.
Hypertension is a significant risk factor for heart failure (HF). Since hypertension definition varies across guidelines, identifying blood pressure (BP) categories that should be targeted to prevent HF is required. We, therefore, investigated the association between hypertension per the 2017 American College of Cardiology/American Heart Association (ACC/AHA) and 2018 European Society of Cardiology/European Society of Hypertension (ESC/ESH) guidelines and HF risk. This prospective cohort study included randomly selected 2809 urban Japanese people from the Suita Study. Cox regression was used to assess HF risk, in the form of hazard ratios (HRs) and 95% confidence intervals (95% CIs), for different BP categories in both guidelines, compared to a reference category defined as systolic BP (SBP) <120 mmHg and diastolic BP (DBP) <80 mmHg. Within 8 years of median follow-up, 339 HF cases were detected. Per the 2017 ACC/AHA guidelines, hypertension I and II and isolated systolic hypertension were associated with increased HF risk: HRs (95% CIs) = 1.81 (1.33-2.47), 1.68 (1.24-2.27), and 1.64 (1.13-2.39), respectively. Per the 2018 ESC/ESH guidelines, high-normal BP, hypertension I, II, and III, and isolated systolic hypertension were associated with increased HF risk: HRs (95% CIs) = 1.88 (1.35-2.62), 1.57 (1.13-2.16), 2.10 (1.34-3.29), 2.57 (1.15-5.77), and 1.51 (1.04-2.19), respectively. In conclusion, hypertension and isolated systolic hypertension per the 2017 ACC/AHA and 2018 ESC/ESH guidelines and high-normal BP per the 2018 ESC/ESH guidelines are risk factors for HF.
高血压是心力衰竭（HF）的一个重要风险因素。由于高血压的定义在不同指南中存在差异，因此需要确定应针对哪些血压（BP）类别来预防HF。因此，我们研究了根据2017年美国心脏病学会/美国心脏协会（ACC/AHA）和2018年欧洲心脏病学会/欧洲高血压学会（ESC/ESH）指南定义的高血压与HF风险之间的关联。这项前瞻性队列研究从吹田研究中随机选取了2809名日本城市居民。采用Cox回归分析评估两种指南中不同BP类别发生HF的风险，以风险比（HRs）和95%置信区间（95% CIs）表示，并与定义为收缩压（SBP）<120 mmHg和舒张压（DBP）<80 mmHg的参考类别进行比较。在中位随访的8年内，共检测到339例HF病例。根据2017年ACC/AHA指南，1级和2级高血压以及单纯收缩期高血压与HF风险增加相关：HRs（95% CIs）分别为1.81（1.33 - 2.47）、1.68（1.24 - 2.27）和1.64（1.13 - 2.39）。根据2018年ESC/ESH指南，血压正常高值、1级、2级和3级高血压以及单纯收缩期高血压与HF风险增加相关：HRs（95% CIs）分别为1.88（1.35 - 2.62）、1.57（1.13 - 2.16）、2.10（1.34 - 3.29）、2.57（1.15 - 5.77）和1.51（1.04 - 2.19）。总之，根据2017年ACC/AHA和2018年ESC/ESH指南定义的高血压和单纯收缩期高血压以及根据2018年ESC/ESH指南定义的血压正常高值均为HF的风险因素。
