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Abstract: PO1763

Achievement of Blood Pressure Target and Risk of Major Adverse Cardiovascular and Cerebrovascular Events in Patients with Metabolic Syndrome

Session Information

Category: Hypertension and CVD

  • 1401 Hypertension and CVD: Epidemiology, Risk Factors, and Prevention

Authors

  • Lim, Jimin, Keimyung University School of Medicine, Daegu, Daegu, Korea (the Republic of)
  • Lee, Soojin, Eulji University Hospital in Uijeongbu, Uijeongbu-si, Gyeonggi-do, Korea (the Republic of)
  • Kwon, Jungheon, Keimyung University School of Medicine, Daegu, Daegu, Korea (the Republic of)
  • Paek, Jin hyuk, Keimyung University School of Medicine, Daegu, Daegu, Korea (the Republic of)
  • Park, Woo Yeong, Keimyung University School of Medicine, Daegu, Daegu, Korea (the Republic of)
  • Jin, Kyubok, Keimyung University School of Medicine, Daegu, Daegu, Korea (the Republic of)
  • Han, Seungyeup, Keimyung University School of Medicine, Daegu, Daegu, Korea (the Republic of)
  • Kim, Dong Ki, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea (the Republic of)
  • Kim, Yaerim, Keimyung University School of Medicine, Daegu, Daegu, Korea (the Republic of)
Background

Metabolic syndrome (MetS) is closely related to adversely cardiovascular morbidities and mortality. Among the components of MetS, controlling the hypertension might provide the highest yield in reducing major cerebro-cardiovascular events (MACCE). Herein, we aimed to investigate the impact of control of hypertension on the development of MACCE and all-cause mortality according to the presence of MetS.

Methods

We performed a nationwide population-based study using the national health insurance database of South Korea. Among 2,998,127 subjects with hypertension who received more than 3 times national health screenings from 2003 to 2011, a total of 1,920,601 subjects were included in the study. The study group was divided by the presence of the MetS and the degree of control of blood pressure (BP), 1) intensive well-controlled (well-C) (SBP <120 and DBP <70), 2) standard well-C (SBP 120-130 and DBP 70-80), 3) uncontrolled subgroup 1(U-S1) (SBP 130-159 or DBP 80-99), and 4) uncontrolled subgroup 2 (U-S2) (SBP ≥160 or DBP ≥100). The main study outcome was all-cause mortality and composite MACCE. The study outcomes were investigated using multivariable Cox-regression analysis after adjusting for clinical variables.

Results

There were 945,243 (49.2%) subjects with 2 or more components of MetS. Among them, 142,991, 179,041, 562,725, and 60,486 subjects were grouped in the well-C intensive, well-C standard, U-S1, and U-S2, respectively. Compared to the well-C standard group, both intensively controlled group (hazard ratio [HR]; 1.123, 95% confidence interval [95% CI]; 1.062-1.186) and uncontrolled group (HR: 1.106; 95% CI 1.061-1.153 in U-S1, and (HR: 1.353; 95% CI 1.265-1.448) in U-S2 group) was associated with increased risk of composite MACCE. In addition, the risk of all-cause mortality in subjects with MetS was increased in well-C intensive group (HR: 1.197; 95% CI 1.143-1.254) and U-S2 group (HR: 1.211; 95% CI 1.211-1.138-1.287), compared to the well-C standard group.

Conclusion

Uncontrolled hypertension increased risk for MACCE and all-cause mortality in patients with or without MetS, whereas intensive control of BP also increased risk. Therefore, proper targeting the blood pressure is important to reduce the risk of major clinical outcomes irrespective of the presence of MetS.