Isolated Diastolic Hypertension: No difference between the old and new cut-off for cardiovascular outcome

IDH as defined by the 2017 ACC/AHA blood pressure guideline may not be associated with increased risk for cardiovascular outcomes.

Isolated diastolic hypertension using the stricter hypertension definition imposed by the American College of Cardiology/American Heart Association (ACC/AHA) in 2017 is not associated with adverse cardiovascular outcomes, according to a JAMA report.

The ACC/AHA 2017 hypertension cutoff for diastolic blood pressure is 80 mm Hg, while the older Joint National Committee 7 (JNC7) cutoff was more lenient at 90 mm Hg.

First, researchers studied roughly 9600 adults who participated in the National Health and Nutrition Examination Survey (NHANES) during 2013–2016. The prevalence of isolated diastolic hypertension was estimated at 6.5% using the ACC/AHA 2017 cutoff and 1.3% using the JNC7 cutoff.

Next, the researchers examined long-term outcomes according to isolated diastolic hypertension in another large U.S. cohort. During a median follow-up of 25 years, isolated diastolic hypertension using either the ACC/AHA 2017 or JNC7 cutoff was not significantly associated with increased risks for incident atherosclerotic cardiovascular events, heart failure, or chronic kidney disease, compared with normal blood pressure.

The researchers say the findings cast doubt on the pathogenicity of isolated diastolic hypertension.

Read the article here.

Source: NEJM Journal Watch

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