Kaiser Permanente Northern California (Oakland & Redwood City) and Brigham and Women’s Hospital conducted a retrospective study examining the relationship between systolic and diastolic hypertension and cardiovascular outcomes using data from 1.3 million adults in general outpatient population over an eight year period. The team produced a composite of myocardial infarction (MI), ischemic stroke, or hemorrhagic stroke. The study revealed that both systolic and diastolic blood pressure (BP) independently influence the risk of adverse cardiovascular events regardless of the definition of hypertension.
The results showed that a continuous burden of systolic hypertension (≥140 mm Hg) and diastolic hypertension (≥90 mm Hg) independently predicted the composite outcome. Similar results were observed with the former, lower threshold of hypotension (≥130/80 mm Hg) and even with systolic and diastolic BP used as predictors without hypertension thresholds.
The study runs counter to decades of previous research indicating high systolic BP is more likely than diastolic BP to result in adverse outcomes.
The study was published in the New England Journal of Medicine (NEJM).
Deepak Bhatt, MD, MPH, executive director of interventional cardiovascular services, Brigham and Women’s Hospital