Low Diastolic BP Raises Risk of CV Events and Death in Patients With Hypertension
A recent analysis showed that hypertension patients with low diastolic blood pressure (DBP) face higher risk of cardiovascular (CV) events and death, especially those who are older and have a history of coronary artery disease (CAD).
Findings from the analysis were presented on July 14, 2017, at the 22nd World Congress on Heart Disease in Vancouver, British Columbia, Canada.
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In their retrospective data analysis, the researchers evaluated 8237 patients with hypertension using data from the Systolic Blood Pressure Intervention Trial (SPRINT) database. Participants were divided into 3 groups based on their mean DBP. Group 1 participants had a mean DBP of less than 60 mmHg, while mean DBP was between 60 and 79 mmHg in group 2 participants and above 80 mmHg in group 3 participants.
Participants were further classified as having systolic blood pressure (SBP) higher or lower than 135 mmHg.
The study’s primary outcome was the development of adverse CV events, including myocardial infarction (MI), non-MI acute coronary syndrome, heart failure, stroke, or CV-related death.
A total of 814 participants were placed in group 1, 5882 in group 2, and 1588 in group 3. Results indicated that the mean DBP was 55.9 mmHg in group 1, 70.6 mmHg in group 2, and 93.5 mmHg in group 3. A total of 9.58% of group 1 participants experienced the primary outcome, compared with 5.21% of group 2 participants, and 4.34% of group 3 participants.
Group 2 demonstrated a 28% lower risk of developing the primary outcome compared with group 1, while group 3 had a 25% lower risk compared with group 1. There was no significant difference in cardiac index (CI) between groups 2 and 3.
The researchers found that participants with low DBP and co-existing older age and history of CAD were more likely to develop the primary outcome.
“Our results indicate that low DBP is associated with increased incidence of adverse events, and the co-existing history of CAD and increasing age contribute to worse outcomes,” the researchers concluded. “Moreover, the incidence of primary event in the high DBP group was low; arguing against the J curve phenomenon.”
—Christina Vogt
Reference:
Sundaravel SH, Venegas EJ, Kabach M, Chait R, Donath E. Influence of diastolic blood pressure on adverse outcomes in treatment of hypertension. Cardiol. 2017;137(Suppl. 1):91. doi: 10.1159/issn.0008-6312.