The incidence of coronary artery disease in treated hypertension in the case of blood pressure categories. Hungarian Hypertension Registry 2011–2013–2015
Kékes Ede1, Paksy András2, Tóth Kálmán1
1PTE KK, I. sz. Belgyógyászati Klinika, Kardiológiai Tanszék, Pécs
2Aesculap Akadémia, Doktorjelöltek Iskolája, Budapest
Background: Aggressive treatment of blood pressure, too low systolic and diastolic blood pressure can adversely affect the blood supply to organs, especially in the case of coronary heart disease.
Aims: We wanted to analyze the relationship between blood pressure categories and the incidence of coronary artery disease in treated middle-aged and elderly hypertensive patients.
Results: For SBP, the percentage of CAD in the 45–64 age group was lowest in the 120–129 mmHg category (10.5%), and in the 65–84 age group in the 130–139 mmHg category (20.2%). For DBP, the lowest incidence of CAD in the middle age group was 70-79 mmHg category and in the elderly 65–69 mmHg category. In both age groups CAD prevalence increased before and after the nadir. The CAD occurrence showed U phenomenon for SBP and J phenomenon for DBP. Multivariate logistic regression analysis proved the validity of the relationship. Patients with diabetic hypertension had a higher incidence of CAD in both age groups and all blood pressure categories compared with all hypertensive patients treated. For SBP, the nadir of CAD incidence in both age groups was 120–129 mmHg. Under 120 mmHg, the incidence of CAD increased again and was confirmed by regression analysis (U formation). For DBP, the nadir was between 70–79 mmHg, with a modest increase in CAD incidence in middle-aged patients and only a very small increase in the elderly under the nadir. Changes in diastolic blood pressure were not significant by regression analysis.
Conclusion: In hypertensive patients, target blood pressure below 130 mmHg systolic and 70 mmHg diastolic pressure may increase the incidence of coronary artery disease.