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HIGH SYSTOLIC BLOOD PRESSURE IS ASSOCIATED WITH INCIDENT LATENT HEART FAILURE: THE SUITA STUDY

Kokubo, Y.; Watanabe, M.; Higashiyama, A.; Nakao, Y.M.; Miyamoto, Y.

Journal of Hypertension: June 2018 - Volume 36 - Issue - p e16
doi: 10.1097/01.hjh.0000539005.38038.24
ORAL SESSION 2B: ATRIAL FIBRILLATION AND HEART FAILURE: PDF Only
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Objective: Preventing organ dysfunction is essential for the extension of the healthy life expectancy among the high prevalence of longevity populations, but there are few epidemiological studies on heart failure (HF) for residents other than Westerners. We hypothesized that high systolic blood pressure (BP) affects the risk of subsequent latent HF in a general Japanese population.

Design and method: We prospectively followed-up 2,760 participants (average age 66.7 ± 10.4 years) initially free of latent HF for incident latent HF in the Suita Study. B-type natriuretic peptide (BNP) was measured by the CLEIA method. Latent HF was defined as BNP > = 100 pg/mL or HF medication from medical records. Each subject's health status and BNP were checked in biannual medical examinations, and annual questionnaires were also completed by all subjects. BP was measured twice in the sitting position after resting for > = 5 min. The values’ mean was used for the analysis. The endpoint of the follow-up period for incident latent HF was whichever of the following occurred first: the date of the first diagnosis of latent HF, BNP> = 100 pg/mL, or HF medication. We analyzed Cox proportional hazard ratios (HRs) and 95% confidence intervals (CIs) for incident latent HF after adjusting for cardiovascular risk factors.

Results: In 16,856 person-years of follow-up, 270 incident latent HF events occurred. The age- and sex-adjusted HRs (95% CI) for incident latent HF were 1.92 (1.24–2.99) in grade II or III systolic hypertension (> = 160 mmHg) and 1.99 (1.30–3.06) in high pulse pressure > = 60 mmHg, compared with optimal systolic BP (<120 mmHg) and low pulse pressure <40 mmHg, respectively. The multivariable-adjusted HR (95%CIs) for incident latent HF was 2.17 (1.37–3.44), compared with optimal systolic BP. The age- and sex- and multivariable-adjusted HRs (95%CIs) for incident latent HF were 1.34 (1.05–1.72) and 1.09 (0.83–1.43) in antihypertensive drug use, respectively. No association between diastolic BP and incident latent HF was observed.

Conclusions: Our findings are the first to show that grade II or III systolic hypertension is a robust predictive marker of incident latent HF in a general Japanese population.

National Cerebral and Cardiovascular Center, Suita, Japan

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