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Organized by
Nanjing Heart Center
Asian Bifurcation Club (ABC)
Nanjing First Hospital, Nanjing Medical University
Co-organized by
Chinese Society of Cardiology (CSC)
Capacity Building and Continuing Education Center,National Health and Family Planning Commission (CBCEC)
American Society for Cardiovascular Angiography and Interventions (SCAI)
Asian Heart Society (AHS)
Contact Us
Registration Administration of Domestic Representatives
Hongjuan Peng :
+86-13913895477
Haimei Xu +86-13914736846
cbsnj@cbsmd.cn
Registration Administration of Overseas Representatives
Ling Lin : +86 (25) 52271398
+86-13951884596
cbs@cbsmd.cn
Management of Challenging Cases
Yingying Zhao :+86-13815408517
sub@cbsmd.cn
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210006
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> Acute Coronary Syndrom
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Recommended Paper
Management of Acute Myocardial Infarction During the COVID-19 Pandemic
COVID-19 and Thrombotic or Thromboembolic Disease: Implications for Prevention, Antithrombotic Therapy, and Follow-up
CSC Expert Consensus on Principles of Clinical Management of Patients with Severe Emergent Cardiovascular Diseases during the COVID-19 Epidemic
ACC Clinical Bulletin Focuses on Cardiac Implications of Coronavirus (COVID-19)
Other Relevant Articles
Original Research2019; 381:243-251
JOURNAL：N Engl J Med. Article Link
AC Flint, C Conell, DL Bhatt et al. Keywords: hypertension; systolic blood pressure; diastolic blood pressure; multivariable Cox survival analysis; MACE
BACKGROUND - The relationship between outpatient systolic and diastolic blood pressure and cardiovascular outcomes remains unclear and has been complicated by recently revised guidelines with two different thresholds (≥140/90 mm Hg and ≥130/80 mm Hg) for treating hypertension.
METHODS - Using data from 1.3 million adults in a general outpatient population, we performed a multivariable Cox survival analysis to determine the effect of the burden of systolic and diastolic hypertension on a composite outcome of myocardial infarction, ischemic stroke, or hemorrhagic stroke over a period of 8 years. The analysis controlled for demographic characteristics and coexisting conditions.
RESULTS - The burdens of systolic and diastolic hypertension each independently predicted adverse outcomes. In survival models, a continuous burden of systolic hypertension (≥140 mm Hg; hazard ratio per unit increase in z score, 1.18; 95% confidence interval [CI], 1.17 to 1.18) and diastolic hypertension (≥90 mm Hg; hazard ratio per unit increase in z score, 1.06; 95% CI, 1.06 to 1.07) independently predicted the composite outcome. Similar results were observed with the lower threshold of hypertension (≥130/80 mm Hg) and with systolic and diastolic blood pressures used as predictors without hypertension thresholds. A J-curve relation between diastolic blood pressure and outcomes was seen that was explained at least in part by age and other covariates and by a higher effect of systolic hypertension among persons in the lowest quartile of diastolic blood pressure.
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