The different risk factors for isolated diastolic hypertension and isolated systolic hypertension: a national survey

Kun Xie,Yong Li,Haiming Shi,Ying Shan,Liwen Bao,Xiufang Gao

doi:10.1186/s12889-021-11686-9

Kun Xie, Yong Li + Show 4 more

Open Access

https://doi.org/10.1186/s12889-021-11686-9

Copy DOI

Journal: BMC Public Health	Publication Date: Sep 14, 2021
Citations: 11	License type: open-access

Affiliation: Huashan Hospital, Fudan University

Abstract

BackgroundHypertension is highly prevalent and is one of the modifiable risk factors for cardiovascular outcomes. Isolated diastolic hypertension (IDH), however, tends to be ignored due to insufficient recognition. We sought to depict the clinical manifestation of IDH and isolated systolic hypertension (ISH) to find a more efficient way to improve the management.MethodsPatients with primary hypertension aged over 18 years were investigated from all over the country using convenience sampling during 2017–2019. IDH was defined as systolic blood pressure (SBP) < 140 mmHg and diastolic blood pressure (DBP) ≥90 mmHg. ISH was defined as SBP ≥ 140 mmHg and DBP < 90 mmHg.ResultsA total of 8548 patients were screened, and 8475 participants were included. The average age was 63.67 ± 12.78 years, and males accounted for 54.4%. Among them, 361 (4.3%) had IDH, and 2096 had ISH (24.7%). Patients with IDH (54.84 ± 13.21 years) were much younger. Aging turned out to be negatively associated with IDH but positively associated with ISH. Multivariate logistic regression analysis showed BMI was a significant risk factor for IDH (OR 1.30, 95%CI 1.05–1.61, p = 0.018), but not for ISH (OR 1.05, 95%CI 0.95–1.16, p = 0.358). Moreover, smoking was significantly associated with IDH (OR 1.36, 95%CI 1.04–1.78, p = 0.026) but not with ISH (OR 1.04, 95%CI 0.90–1.21, p = 0.653).ConclusionsPatients with IDH were much younger, and the prevalence decreased with aging. BMI and smoking were remarkably associated with IDH rather than ISH. Keeping fit and giving up smoking might be particularly efficient in the management of young patients with IDH.Trial registrationNCT03862183, retrospectively registered on March 5, 2019.

Highlights

Hypertension is highly prevalent and is one of the modifiable risk factors for cardiovascular outcomes
Isolated diastolic hypertension (IDH) was defined as systolic blood pressure (SBP) < 140 mmHg and diastolic blood pressure (DBP) ≥ 90 mmHg; isolated systolic hypertension (ISH) was defined as SBP ≥ 140 mmHg and DBP < 90 mmHg; Systolic and diastolic hypertension (SDH) was defined as SBP ≥ 140 mmHg and DBP ≥ 90 mmHg; Normotension was defined as SBP < 140 mmHg and DBP < 90 mmHg
Males accounted for 54.4%. 18.5% of them had a habit of smoking, and 89.4% were under antihypertensive agents

Summary

Introduction

Hypertension is highly prevalent and is one of the modifiable risk factors for cardiovascular outcomes. We sought to depict the clinical manifestation of IDH and isolated systolic hypertension (ISH) to find a more efficient way to improve the management. Hypertension is highly prevalent and is one of the most modifiable risk factors for cardiovascular mortality and morbidity. Isolated diastolic hypertension (IDH) and isolated systolic hypertension (ISH) are two particular types. McEvoy et al reported that IDH, by 2017 ACC/AHA definitions [2], was not associated with increased cardiovascular outcomes [3]. 21,441 participants, patients aged 35–59 years with stage 1 hypertension defined by the 2017 ACC/AHA guideline had a significantly increased risk of CVD risks over a 15year period. In patients aged ≥60 years, stage 1 hypertension was not associated with increased CVD risks [4]

Methods

Results

Conclusion