NYMC Faculty Publications

Title

Systolic-diastolic Hypertension Versus Isolated Systolic Hypertension and Incident Heart Failure in Older Adults: Insights from the Cardiovascular Health Study

Document Type

Article

Publication Date

May 2017

Department

Medicine

Abstract

BACKGROUND: Isolated systolic hypertension (ISH) is common in older adults and is a risk factor for incident heart failure (HF). We examined the association of systolic-diastolic hypertension (SDH) with incident HF and other outcomes in older adults. METHODS: In the Cardiovascular Health Study (CHS), 5776 community-dwelling adults>/=65years had data on baseline systolic and diastolic blood pressure (SBP and DBP). We excluded those with DBP/=90 and SBP/=140 and DBP/=140 and DBP>/=90mmHg). The main outcome was centrally-adjudicated incident HF over 13years of follow-up. RESULTS: Participants had a mean (+/-SD) age of 73 (+/-6)years, 57% were women, and 16% African American. Incident HF occurred in 25%, 22% and 11% of participants with ISH, SDH and no hypertension, respectively. Compared to no hypertension, multivariable-adjusted hazard ratios (HR) and 95% confidence intervals (CI) for incident HF associated with ISH and SDH were 1.86 (1.51-2.30) and 1.73 (1.23-2.42), respectively. Cardiovascular mortality occurred in 22%, 24% and 9% of those with ISH, SDH and no hypertension, respectively with respective multivariable-adjusted HRs (95% CIs) of 1.88 (1.49-2.37) and 2.30 (1.64-3.24). CONCLUSION: Among older adults with hypertension, both SDH and ISH have similar associations with incident HF and cardiovascular mortality.

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