Author + information
- Ross Fletcher,
- Hans Moore,
- Richard Amdur,
- Raya Kheirbek,
- Farrokh Alemi,
- David Maron,
- Charles Faselis,
- Vasilios Papademetriou and
- Ronald E. Jones
Background: The Veterans Affairs (VA) Electronic Health Record (EHR) contains the vital signs of over 8,000,000 patients, allowing comparisons between blood pressure (BP) control and mortality.
Methods: We reviewed changes in blood pressure (BP) over 15 years (2000-2014). Hypertension (HTN) was defined as having elevated systolic or diastolic BP (>140 or >90) over 3 separate days. Once HTN was diagnosed, the level of control was defined by averaging BPs. We examined Average Systolic Blood Pressure (ASBP), age, and race (Black and White), in the absence of diabetes. All-cause mortality was the main outcome measure.
Results: There were 3,160,608 with HTN out of 8,813,000 patients. In all age groups, the non-diabetics had a higher mortality when blood pressure was 140-150 than when blood pressure was 120-130. When White non-diabetic patients < 60, 60-80, and >80 years old, with ASBP 130-140 were compared with ASBP 140-150, the increase in mortality was 52%, 33%, 16% respectively, and the % point increase was 2.2%, 3.8%, 5.0%. For Blacks, the % increase in mortality was 55%, 39%, 12% with a % point increase of 1.82%, 4.4%, 4.0%.
Conclusions: Non-diabetic patients >60 had a greater % point increase in mortality than patients <60. Blacks had lower mortality than whites in age groups < 60, similar mortality in 60 – 80, and greater mortality in patients >80 years old. The guideline for non-diabetic patients > 60 that allows 140 – 150mm HG ASBP to be considered controlled, may increase mortality and should be reconsidered.
Poster Hall, Hall C
Friday, March 17, 2017, 10:00 a.m.-10:45 a.m.
Session Title: Assessing the Clinical Impact of Blood Pressure Lowering Therapies
Abstract Category: 33. Prevention: Hypertension
Presentation Number: 1105-035
- 2017 American College of Cardiology Foundation