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A lower blood pressure threshold to define hypertension

the effect on prevalence, control rate, and constituent ratio of systolic and/or diastolic hypertension

Lai, Min*; Zhou, Wei*; Wang, Wen-Yin; Wan, Tai-Xuan; Peng, Qiang; Su, Hai

doi: 10.1097/MBP.0000000000000361
Analytical and Statistical Methods

Objective To evaluate the impact of the new US hypertension criteria [systolic blood pressure/diastolic blood pressure (SBP/DBP ≥130/80 mmHg)] on hypertension prevalence and the constituent ratio of three hypertension phenotypes.

Participants and methods This study included 1185 adult participants, who received blood pressure (BP) measurements for 3 days over a 7-day period. At each visit, the BP was measured three times and the average was used as the final value. The criteria of hypertension were if the participant had received treatment with antihypertensive drugs for at least 2 weeks, or SBP/DBP of at least 140/90 mmHg (old criteria) or at least 130/80 mmHg (new criteria) for the untreated participants. The diagnosis of hypertension was made on the basis of first-day BP values (epidemiological method) or the average of the 3-day BP values (clinical method), respectively. The constituent ratios of isolated systolic, isolated diastolic, and systolic–diastolic hypertension were evaluated.

Results When using the old criteria, the overall epidemiological prevalence of hypertension was 41.1% and the overall clinical prevalence of hypertension was 34.8%. When using the new criteria, these values increased to 64.3 and 57.4%, respectively. Meanwhile, against the old criteria, the new criteria increased the constituent ratio of systolic–diastolic hypertension from 24.4 to 50.5% (P<0.001) for the epidemiological method and from 19.1 to 45.7% (P<0.001) for the clinical method in the newly diagnosed hypertensive patients.

Conclusion The hypertension criteria of at least 130/80 mmHg not only significantly increased the clinical prevalence of hypertension, but significantly altered the constituent ratio of three hypertension phenotypes among the newly diagnosed hypertensive patients.

Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China

*Min Lai and Wei Zhou contributed equally to the writing of this article.

Correspondence to Hai Su, MD, PhD, No. 1 Minde Road, Nanchang, Jiangxi 330006, China Tel/fax: +86 0791 8630 1105; e-mail:

Received June 7, 2018

Received in revised form November 27, 2018

Accepted November 28, 2018

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