Table 3.
Rates of CVD events and all-cause mortality among 15,179 REGARDS study participants taking antihypertensive medication by blood pressure category (top panel) and recommendation for pharmacological antihypertensive treatment intensification (bottom panel).
| SBP/DBP, mmHg* | CVD events | All-cause mortality | ||
|---|---|---|---|---|
| Events / Person-years | Rate (95% CI) per 1,000 person-years | Events / Person-years | Rate (95% CI) per 1,000 person-years | |
| <130 and <80 | 873 / 39,821 | 21.9 (20.5, 23.4) | 1,289 / 42,168 | 30.6 (28.9, 32.2) |
| 130–139 or 80–89 | 808 / 36,566 | 22.1 (20.6, 23.6) | 1,151 / 38,984 | 29.5 (27.8, 31.2) |
| ≥140 or ≥90 | 1,014 / 30,201 | 33.6 (31.5, 35.6) | 1,407 / 33,108 | 42.5 (40.3, 44.7) |
| Recommendation for antihypertensive medication intensification by the 2017 ACC/AHA blood pressure guideline (among participants with SBP between 130 and 139 mmHg or DBP between 80 and 89 mmHg)† | ||||
| Not recommended | 2 / 523 | 3.8 (0.0, 9.1) | 3 / 538 | 5.6 (0.0, 11.9) |
| Recommended | 806 / 36,043 | 22.4 (20.8, 23.9) | 1,148 / 38,446 | 29.9 (28.1, 31.6) |
ACC: American College of Cardiology; AHA: American Heart Association; CVD: cardiovascular disease; REGARDS: REasons for Geographic and Racial Differences in Stroke.
Blood pressure categories are mutually exclusive. Participants whose SBP and DBP correspond to two separate categories were assigned to the higher blood pressure group.
Analyses of the recommendation for antihypertensive medication intensification were restricted to participants with SBP between 130 and 139 mmHg or DBP between 80 and 89 mmHg. Recommendations for antihypertensive medication intensification according to the 2017 ACC/AHA blood pressure guideline include SBP between 130 and 139 mmHg or DBP between 80 and 89 mmHg with diabetes, chronic kidney disease, a history of CVD or a 10-year predicted CVD risk ≥10%, age <65 years, or age ≥65 years with SBP ≥130 mmHg. Participants ≥65 years of age with SBP <130 mmHg, DBP between 80 and 89 mmHg and a 10-year predicted CVD risk <10% who do not have diabetes, chronic kidney disease or a history of CVD are not recommended antihypertensive medication intensification according to the 2017 ACC/AHA blood pressure guideline.
The median follow-up for CVD events was 7.8 years (maximum 11.8 years). The median follow-up for all-cause mortality was 8.2 years (maximum 11.9 years).