Association of Isolated Diastolic Hypertension as Defined by the 2017 ACC/AHA Guideline with CVO

JAMA. 2020;323(4):329-338. doi:10.1001/jama.2019.21402

John W. McEvoy, MBBCh, MEd, MHS1,2,3; Natalie Daya, MPH3; Faisal Rahman, MD2; et al

Key Points

Question What is the prevalence of isolated diastolic hypertension (IDH) in the United States when defined by the 2017 American College of Cardiology (ACC)/American Heart Association (AHA) blood pressure guideline vs the 2003 Joint National Committee (JNC7) guideline and what is the prognosis of individuals with IDH by the 2017 ACC/AHA definition?

Findings In a nationally representative US cross-sectional study that included 9590 adults, the estimated prevalence of IDH based on the 2017 ACC/AHA guideline vs the JNC7 guideline was 6.5% vs 1.3%, respectively. In a longitudinal analysis that included 8703 adults, there was no significant association between IDH as defined by the 2017 ACC/AHA guideline and incident atherosclerotic cardiovascular disease, heart failure, or chronic kidney disease.

Meaning IDH as defined by the 2017 ACC/AHA blood pressure guideline may not be associated with increased risk for cardiovascular outcomes.

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