Abstract 14133: Blood Pressure Lowering Less Than 130 mmHg is Best but Less Than 120 mmHg is Worst in a General Japanese Population
Background: The SPRINT trial reported the blood pressure (BP) lowering to 120 mmHg in some high-risk patients and meta-analyses supported intensive BP lowering. However, impact of BP lowering and adverse effect of BP lowering may depend on different cardiovascular outcomes. In Japan, stroke is predominant cardiovascular disease.
Methods: We studied 2,209 subjects (mean age 63±8 years, men 29%) with antihypertensive medication out of 16,461 who had the annual health checkup offered to adult citizens of Moriguchi city, Osaka, Japan in 1997. The subjects were divided into 5 groups according to systolic BP at the checkup in 1997. Proportional hazards regression analyses adjusted for age, sex, smoking status, diabetes, history of cardiovascular disease, drinking habit and hyperlipidemia were used to assess the association of systolic BP categories with mortality.
Results: During a mean follow-up of 14.1±4.1 years, there were 462 deaths. Of those, there were 150 cardiovascular deaths including 37 coronary deaths, 50 stroke deaths with 30 ischemic stroke deaths. Number of death and mortality according to the systolic BP group and hazard ratios (HR) relative to the systolic BP of 120-129 mmHg group with 95% confidence intervals (CI) were presented in the table. Among 5 groups, all-cause mortality and all cardiovascular mortality were the lowest in the 120-129 mmHg group, whereas the highest in the <120 mmHg group. Compared to the 120-129 mmHg group, the <120 mmHg group had significantly higher cardiovascular mortality (HR=2.10, 95%CI=1.07 to 4.12, p=0.0304), stroke mortality (HR=7.02, 95%CI=1.54 to 32.1, p=0.0120), and ischemic stroke mortality (HR=12.7, 95%CI=1.60 to 100.1, p=0.0161).
Conclusions: In subjects who were receiving antihypertensive medication, systolic BP of <120 mmHg had significantly higher cardiovascular, stroke, and ischemic stroke mortality compared to that of 120-129 mmHg.
Author Disclosures: H. Tsuji: None. I. Shiojima: None.
- © 2016 by American Heart Association, Inc.