Lee, Jae-Woo; Shin, Sang-Jun; Kim, Joungyoun; Kang, Hee-Taik
American journal of hypertension
2022Jul ; 35 ( 7 ) :647-655.
PMID : 35363861
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Lee, Jae-Woo -
Shin, Sang-Jun -
Kim, Joungyoun -
Kang, Hee-Taik -
ABSTRACT
Background: This study aimed to investigate the association of pulse pressure (PP) with the cardio-cerebrovascular disease (CCVD) risk and all-cause mortality according to blood pressure level using Korean national cohort data.
Methods: This study was retrospectively designed and based on the Korean National Health Insurance Service-National Health Screening Cohort. Participants aged 40-69 years at baseline were categorized into normal, elevated, stage 1, and stage 2 groups according to blood pressure. Each group was further classified into 5 groups separated by 10-mm Hg increments in PP. The primary composite outcome was defined as CCVDs and all-cause mortality. Cox proportional hazards regression models were adopted after stepwise adjustment for confounders to investigate the composite outcome.
Results: During the follow-up period (median follow-up period, 12.0 years), the primary composite outcome occurred in 18,444 (15.0%) of 122,783 men and 10,096 (11.4%) of 88,550 women. After complete adjustment for confounders, in the stage 1 hypertensive men, the hazard ratio (95% confidence intervals [CIs]) of the 31-40, 41-50, 51-60, and >60 mm Hg PP groups was 1.112 (1.013-1.221), 1.035 (0.942-1.137), 1.009 (0.907-1.123), and 1.324 (1.130-1.551) in comparison with the ¡Â30 mm Hg PP group. In the stage 2 hypertensive men, the HRs (95% CIs) were 1.069 (0.949-1.204), 1.059 (0.940-1.192), 1.123 (0.999-1.263), and 1.202 (1.061-1.358) compared to the ¡Â30 mm Hg PP group. However, these associations were not significant in women.
Conclusions: Hypertensive men with an increased PP have an increased risk of CCVDs and all-cause mortality.
keyword
blood pressure; cardiovascular disease; cerebrovascular disease; hypertension; pulse pressure; systolic blood pressure
MESH
Blood Pressure/physiology, *Cerebrovascular Disorders, Cohort Studies, Female, Humans, *Hypertension/diagnosis/epidemiology, Male, Republic of Korea/epidemiology, Retrospective Studies, Risk Factors
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