Different associations of blood pressure with cardiovascular disease morbidity and mortality according to age groups

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: SUN 758-779-Cardiometabolic Risk & Vascular Biology
Clinical
Sunday, June 16, 2013: 1:45 PM-3:45 PM
Expo Halls ABC (Moscone Center)

Poster Board SUN-761
Nam Hoon Kim*1, Jae Hee Ahn1, Ji Hee Yu1, Ho Cheol Hong1, Hae Yoon Choi1, Yoon Jung Kim1, Hye Jin Yoo1, Hee Young Kim1, Ji A Seo1, Sin Gon Kim1, Kyung Mook Choi1, Sei Hyun Baik1, Dong Seop Choi1, Chol Shin2 and Nan Hee Kim1
1College of Medicine, Korea University, Seoul, South Korea, 2Korea University Ansan Hospital, Ansan, South Korea
Background

 Higher blood pressure (BP) increases cardiovascular disease (CVD) morbidity and mortality. However, several studies indicated the low blood pressure also could be harmful, especially in the elderly or those who with comorbidities. Therefore, we aimed to determine whether the impact of BP categories on CVD morbidity and mortality differs according to different age groups from the large cohort study.

Methods

A total of 8740 individuals aged over 40 years (mean age, 52.2 ± 8.9 years) from the Korean Genome and Epidemiology study were followed from 2001 to 2011. On the basis of baseline blood pressure, subjects were categorized to optimal (< 120/80 mmHg), normal (120-129/80-84 mmHg), high normal (130-139/85-89 mmHg), hypertension (≥ 140/90 mmHg) according to the European Society of Hypertension and European Society of Cardiology (ESH/ESC) criteria. All participants were also assigned to three age groups (<54, 55-64, ≥ 65years). CVD morbidity was defined as any CVD related outcomes including angina, myocardial infarction, heart failure and stroke. Cox proportional hazards models including time dependent covariates were used to estimate hazard ratios (HRs) for CVD outcomes.

Results

During 10-years of follow-up, 518 CVD-related events occurred, and 74 subjects died of CVD. Compared with optimal BP group, high normal BP and hypertension groups had significantly increased hazard ratio of combined CVD morbidity and mortality. (1.53 (95% CI, 1.11-2.11), 1.62 (1.20-2.18), respectively). When analyzed confined to the youngest age group (< 54 years), the adjusted hazard ratio of combined CVD morbidity and mortality was increased linearly in normal BP (2.30 (1.39-3.82)), high normal (2.57 (1.43-4.60)), and hypertension (2.79 (1.63-4.78)) groups after adjusting for sex, age, body mass index, plasma fasting glucose, serum triglyceride, high-density lipoprotein cholesterol, smoking, alcohol, and level of exercise. However, in the older age groups (55-64, ≥ 65years), any significant associations between BP categories and CVD outcomes were not observed.

Conclusion

 Even small increments of blood pressure increased cardiovascular morbidity and mortality risk in the younger adults (< 54yesrs). However, this relationship was not evident in older individuals.

Nothing to Disclose: NHK, JHA, JHY, HCH, HYC, YJK, HJY, HYK, JAS, SGK, KMC, SHB, DSC, CS, NHK

*Please take note of The Endocrine Society's News Embargo Policy at http://www.endo-society.org/endo2013/media.cfm