Abstract P400: Relative Contributions of Systolic and Diastolic Blood Pressure to Adverse Cardiovascular Outcomes in an Outpatient Cohort of 1.3 Million Adults

• Published in: Hypertension (Dallas, Tex. 1979) Tex. 1979), 2017-09, Vol.70 (suppl_1)
• Main Authors: Flint, Alexander C, Conell, Carol, Ren, Xiushui, Banki, Nader, Chan, Sheila L, Rao, Vivek A, Melles, Ron B, Bhatt, Deepak L
• Format: Article
• Language: English
• ISSN: 0194-911X; 1524-4563
• DOI: 10.1161/hyp.70.suppl_1.p400

Abstract only Systolic hypertension is believed to have a greater influence than diastolic hypertension on adverse cardiovascular events. We tested this hypothesis using data from an integrated healthcare system, with 36.8 million measures from 1.3 million adults. Increasing SBP was associated with risk of a composite outcome of MI, ischemic stroke, or hemorrhagic stroke (Fig A). DBP showed a very different relationship with outcomes, with higher risk at the lowest and highest levels of DBP (Fig B). We examined the impact of systolic and diastolic pressures in multivariable survival analysis controlling for age, sex, race, and comorbidities using two different approaches. We first used the burden of systolic (SBP>=140) and diastolic (DBP>=90) hypertension as predictors. Both systolic burden (hazard ratio [HR] 1.17 for z-score, 95% CI 1.16 to 1.18, P78). Again, both SBP (HR 1.39 for z-score, 95% CI 1.37 to 1.41, P