Association between isolated diastolic hypertension and cardiovascular disease based on different guideline definitions in a rural population in southern Xinjiang
Objective To explore the association between isolated diastolic hypertension(IDH)based on different guideline definitions and the risk of cardiovascular disease(CVD)in rural areas of southern Xinjiang.Methods The resident population of the third division of the Xinjiang Production and Construction Corps was selected as the study population.According to the definition of IDH in the 2017 American College of Cardiology/American Heart Association(ACC/AHA)guideline and the 2020 Chinese Hypertension Guideline,6834 and 8960 study subjects were included,respectively.The Log-rank tests were used to compare the differences in the cumulative incidence of CVD events between patients with IDH defined by different guidelines and normotensive participants;Cox proportional risk regression models were used to examine the association between IDH and CVD risk.Results The prevalence of IDH as defined by the ACC/AHA guidelines was 5.4%higher than those defined by the Chinese guidelines.None of the differences in the cumulative preva-lence of CVD between IDH patients with different guideline definitions and normotensive participants were statistically significant(ACC/AHA guideline,χ2=0.07,P=0.80;Chinese guideline,χ2=3.85,P=0.05).The cumulative incidence of CVD in IDH pa-tients under the ACC/AHA guideline definition was lower than that of those under the Chinese guideline definition(6.14%vs 9.88%,χ2=5.22,P=0.02).Compared with normotensive individuals,the strength of the association between IDH and CVD risk as defined by the Chinese guideline was higher than that defined by the ACC/AHA guideline,but the difference was not statistically significant,HR(95%CI):1.411(0.999～1.993),1.037(0.788～1.364).Conclusions In the rural population of southern Xinjiang,the ap-plication of the new blood pressure threshold defined by the 2017 ACC/AHA guidelines can screen out more patients with IDH,which is conducive to early and effective prevention and control measures.
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