Stage 1 hypertension by the 2017 American College of Cardiology/American Heart Association hypertension guidelines and risk of cardiovascular disease events: systematic review, meta-analysis, and estimation of population etiologic fraction of prospective cohort studies. Issue 4 (April 2020)

• Record Type: Journal Article
• Authors: Han, Minghui; Chen, Qing; Liu, Leilei; Li, Quanman; Ren, Yongcheng; Zhao, Yang; Liu, Dechen; Zhang, Dongdong; Liu, Feiyan; Chen, Xu; Cheng, Cheng; Guo, Chunmei; Zhou, Qionggui; Tian, Gang; Qie, Ranran; Huang, Shengbing; Wu, Xiaoyan; Liu, Yu; Li, Honghui; Sun, Xizhuo; Lu, Jie; Hu, Dongsheng; Zhang, Ming
• Is Part Of: Journal of hypertension. Volume 38:Issue 4(2020:Apr.)
• Publication Date: 2020-04
• Subjects: cardiovascular disease events -- meta-analysis -- population etiologic fraction -- prospective cohort studies -- stage 1 hypertension; Hypertension -- Periodicals; Hypertension -- Periodicals; 616.132005
• DOI: 10.1097/HJH.0000000000002321
• Languages: English
• ISSNs: 1473-5598

Abstract

Abstract : Background: Epidemiological studies reported an inconsistent association between stage 1 hypertension (SBP 130–139 mmHg or DBP 80–89 mmHg) defined by the 2017 American College of Cardiology/American Heart Association hypertension guidelines and cardiovascular disease (CVD) events. In addition, the proportion of CVD events that could be prevented with effective control of stage 1 hypertension is unknown. Objectives: To assess the association between stage 1 hypertension and CVD events and estimate the population etiologic fraction. Methods: PubMed, Embase, and Web of Science databases were searched from 1 January 2017 to 22 September 2019. Normal BP was considered SBP less than 120 mmHg and DBP less than 80 mmHg. Hazard ratios and 95% confidence intervals (95% CIs) were pooled by using a random-effects model. Results: We included 11 articles (16 studies including 3 212 447 participants and 65 945 events) in the analysis. Risk of CVD events was increased with stage 1 hypertension versus normal BP (hazard ratio 1.38, 95% CI 1.28–1.49). On subgroup analyses, stage 1 hypertension was associated with coronary heart disease (CHD) (hazard ratio 1.30, 95% CI 1.20–1.41), stroke (1.39, 1.27–1.52), CVD morbidity (1.42, 1.32–1.53), and CVD mortality (1.34, 1.05–1.71). The population etiologic fraction for the association of CVD events, CHD, stroke, CVD morbidity, and CVD mortality with stage 1 hypertension was 12.90, 10.48, 12.71, 14.03, and 11.69%, respectively. Conclusion: Stage 1 hypertension is associated with CVD events, CVD morbidity, CVD mortality, CHD, and stroke. Effective control of stage 1 hypertension could prevent more than 10% of CVD events. Abstract : Supplemental Digital Content is available in the text