Abstract TP431: Association of Systolic Blood Pressure and Cardiovascularrisk According to Hemoglobin Concentration

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Introduction: We evaluated whether the optimal cutoff of blood pressure to reduce cardiovascular risk is different according to hemoglobin (Hb) concentration and its changing pattern using the National Health Insurance Service-Health Screening Cohort. Methods: The study population consisted of individuals who underwent both 2002-2003 and 2004-2005 health examinations. Individuals who were diagnosed with cardiovascular disease or who died before index date of 1 January 2006 were excluded. The primary outcome of the study was the association between systolic blood pressure (SBP) and MACE (composite of myocardial infarction, stroke, and cardiovascular death) according to Hb concentration. Hazard ratios (HR) were calculated using Cox regression analysis adjusted for age and sex. Results: A total of 290573 were included in the analysis. During the follow up period from 1 January 2006 to 31 December 2013, a total of 18292 experienced MACE. There was a significant interaction between SBP and Hb concentration with regard to cardiovascular diseases (p for interaction= 0.07). Among the subjects with Hb <10, a significant increment of MACE was observed when SBP ≥140 mmHg. HR for MACE increased when SBP ≥130mmHg among the subjects with 10≤ Hb <11 and 11≤ Hb <12. HR for MACE increased when SBP ≥ 120 mmHg among the subjects with 12≤ Hb <13, 13≤ Hb <15, and 15≤ Hb. Cardiovascular risk was the lowest in SBP below 120mmHg and cut off value for increasing cardiovascular risk was 120 mmHg or above in subjects who maintain normal range of hemoglobin level and whose hemoglobin concentration changed from anemia to normal range. However, individuals who maintain anemic state and whose hemoglobin concentration changed from normal range to anemia, SBP threshold for increasing cardiovascular risk was equal or above 130 mmHg . Conclusion: The threshold of SBP which increases cardiovascular risk may be different according to the hemoglobin concentration and change pattern of hemoglobin.