{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T08:16:25Z","timestamp":1768464985619,"version":"3.49.0"},"reference-count":19,"publisher":"Oxford University Press (OUP)","issue":"14","license":[{"start":{"date-parts":[[2022,9,1]],"date-time":"2022-09-01T00:00:00Z","timestamp":1661990400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Ministry of Health, Labour and Welfare, Japan","award":["21AA2007"],"award-info":[{"award-number":["21AA2007"]}]},{"DOI":"10.13039\/501100001700","name":"Ministry of Education, Culture, Sports, Science and Technology","doi-asserted-by":"crossref","award":["20H03907"],"award-info":[{"award-number":["20H03907"]}],"id":[{"id":"10.13039\/501100001700","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001700","name":"Ministry of Education, Culture, Sports, Science and Technology","doi-asserted-by":"crossref","award":["21H03159"],"award-info":[{"award-number":["21H03159"]}],"id":[{"id":"10.13039\/501100001700","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001700","name":"Ministry of Education, Culture, Sports, Science and Technology","doi-asserted-by":"crossref","award":["21K08123"],"award-info":[{"award-number":["21K08123"]}],"id":[{"id":"10.13039\/501100001700","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,10,20]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Few studies have examined the relationship of blood pressure (BP) change in adults with elevated BP or stage 1 hypertension according to the American College of Cardiology (ACC)\/American Heart Association (AHA) guideline with cardiovascular outcomes. We sought to identify the effect of BP change among individuals with elevated BP or stage 1 hypertension on incident heart failure (HF) and other cardiovascular diseases (CVDs).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>We conducted a retrospective cohort study including 616 483 individuals (median age 46 years, 73.7% men) with elevated BP or stage 1 hypertension based on the ACC\/AHA BP guideline. Participants were categorized using BP classification at one-year as normal BP (n = 173 558), elevated BP\/stage 1 hypertension (n = 367 454), or stage 2 hypertension (n = 75 471). The primary outcome was HF, and the secondary outcomes included (separately) myocardial infarction (MI), angina pectoris (AP), and stroke. Over a mean follow-up of 1097 \u00b1 908 days, 10 544 HFs, 1317 MIs, 11 070 APs, and 5198 strokes were recorded. Compared with elevated BP\/stage 1 hypertension at one-year, normal BP at one-year was associated with a lower risk of developing HF [hazard ratio (HR): 0.89, 95% CI:0.85\u20130.94], whereas stage 2 hypertension at one-year was associated with an elevated risk of developing HF (HR:1.43, 95% CI:1.36\u20131.51). This association was also present in other cardiovascular outcomes including MI, AP, and stroke. The relationship was consistent in all subgroups stratified by age, sex, baseline BP category, and overweight\/obesity.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>A one-year decline in BP was associated with the lower risk of HF, MI, AP, and stroke, suggesting the importance of lowering BP in individuals with elevated BP or stage 1 hypertension according to the ACC\/AHA guideline to prevent the risk of developing CVD.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/eurjpc\/zwac193","type":"journal-article","created":{"date-parts":[[2022,9,1]],"date-time":"2022-09-01T07:38:25Z","timestamp":1662017905000},"page":"1921-1929","source":"Crossref","is-referenced-by-count":5,"title":["Reduction in blood pressure for elevated blood pressure\/stage 1 hypertension according to the American College of Cardiology\/American Heart Association guideline and cardiovascular outcomes"],"prefix":"10.1093","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2553-6170","authenticated-orcid":false,"given":"Hidehiro","family":"Kaneko","sequence":"first","affiliation":[{"name":"The Department of Cardiovascular Medicine, The University of Tokyo , 7-3-1, Hongo, Bunkyo-ku, 113-8655, Tokyo , Japan"},{"name":"The Department of Advanced Cardiology, The University of Tokyo , Tokyo , Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuichiro","family":"Yano","sequence":"additional","affiliation":[{"name":"Department of Advanced Epidemiology, NCD Epidemiology Research Center, Shiga University of Medical Science , Shiga , Japan"},{"name":"The Department of Family Medicine and Community Health, Duke University , Durham, NC , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuta","family":"Suzuki","sequence":"additional","affiliation":[{"name":"The Department of Cardiovascular Medicine, The University of Tokyo , 7-3-1, Hongo, Bunkyo-ku, 113-8655, Tokyo , Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akira","family":"Okada","sequence":"additional","affiliation":[{"name":"Department of Prevention of Diabetes and Lifestyle-Related Diseases, Graduate School of Medicine, The University of Tokyo , Tokyo , Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hidetaka","family":"Itoh","sequence":"additional","affiliation":[{"name":"The Department of Cardiovascular Medicine, The University of Tokyo , 7-3-1, Hongo, Bunkyo-ku, 113-8655, Tokyo , Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satoshi","family":"Matsuoka","sequence":"additional","affiliation":[{"name":"The Department of Cardiovascular Medicine, The University of Tokyo , 7-3-1, Hongo, Bunkyo-ku, 113-8655, Tokyo , Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katsuhito","family":"Fujiu","sequence":"additional","affiliation":[{"name":"The Department of Cardiovascular Medicine, The University of Tokyo , 7-3-1, Hongo, Bunkyo-ku, 113-8655, Tokyo , Japan"},{"name":"The Department of Advanced Cardiology, The University of Tokyo , Tokyo , Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nobuaki","family":"Michihata","sequence":"additional","affiliation":[{"name":"The Department of Health Services Research, The University of Tokyo , Tokyo , Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Taisuke","family":"Jo","sequence":"additional","affiliation":[{"name":"The Department of Health Services Research, The University of Tokyo , Tokyo , Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Norifumi","family":"Takeda","sequence":"additional","affiliation":[{"name":"The Department of Cardiovascular Medicine, The University of Tokyo , 7-3-1, Hongo, Bunkyo-ku, 113-8655, Tokyo , Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroyuki","family":"Morita","sequence":"additional","affiliation":[{"name":"The Department of Cardiovascular Medicine, The University of Tokyo , 7-3-1, Hongo, Bunkyo-ku, 113-8655, Tokyo , Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2534-0939","authenticated-orcid":false,"given":"Koichi","family":"Node","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Saga University , Saga , Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony J","family":"Viera","sequence":"additional","affiliation":[{"name":"The Department of Family Medicine and Community Health, Duke University , Durham, NC , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joao A C","family":"Lima","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Johns Hopkins University School of Medicine , Baltimore, MD , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7505-2599","authenticated-orcid":false,"given":"Suzanne","family":"Oparil","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham , Birmingham, AL , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carolyn S P","family":"Lam","sequence":"additional","affiliation":[{"name":"National Heart Centre Singapore , Singapore"},{"name":"Duke-NUS Medical School , Singapore"},{"name":"Department of Cardiology, University of Groningen, University Medical Centre Groningen , Groningen , Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert M","family":"Carey","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Virginia Health System , Charlottesville, VA , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hideo","family":"Yasunaga","sequence":"additional","affiliation":[{"name":"The Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo , Tokyo , Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Issei","family":"Komuro","sequence":"additional","affiliation":[{"name":"The Department of Cardiovascular Medicine, The University of Tokyo , 7-3-1, Hongo, Bunkyo-ku, 113-8655, Tokyo , Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2022,9,1]]},"reference":[{"key":"2022102020072900900_zwac193-B1","first-page":"e484","article-title":"2017 ACC\/AHA\/AAPA\/ABC\/ACPM\/AGS\/APhA\/ASH\/ASPC\/NMA\/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology\/American Heart Association task force on clinical practice guidelines","volume":"138","author":"Whelton","year":"2018","journal-title":"Circulation"},{"key":"2022102020072900900_zwac193-B2","doi-asserted-by":"crossref","first-page":"1774","DOI":"10.1001\/jama.2018.13551","article-title":"Association of blood pressure classification in young adults using the 2017 American College of Cardiology\/American Heart Association blood pressure guideline with cardiovascular events later in life","volume":"320","author":"Yano","year":"2018","journal-title":"JAMA"},{"key":"2022102020072900900_zwac193-B3","doi-asserted-by":"crossref","first-page":"1783","DOI":"10.1001\/jama.2018.16501","article-title":"Association of blood pressure classification in Korean young adults according to the 2017 American college of cardiology\/American heart association guidelines with subsequent cardiovascular disease events","volume":"320","author":"Son","year":"2018","journal-title":"JAMA"},{"key":"2022102020072900900_zwac193-B4","doi-asserted-by":"crossref","first-page":"2244","DOI":"10.1161\/CIRCULATIONAHA.120.052624","article-title":"Association of blood pressure classification using the 2017 American College of Cardiology\/American Heart Association blood pressure guideline with risk of heart failure and atrial fibrillation","volume":"143","author":"Kaneko","year":"2021","journal-title":"Circulation"},{"key":"2022102020072900900_zwac193-B5","doi-asserted-by":"crossref","first-page":"798","DOI":"10.1161\/CIRCULATIONAHA.117.027362","article-title":"Incident cardiovascular disease among adults with blood pressure &lt;140\/90 mm Hg","volume":"136","author":"Tajeu","year":"2017","journal-title":"Circulation"},{"key":"2022102020072900900_zwac193-B6","doi-asserted-by":"crossref","first-page":"e017963","DOI":"10.1161\/JAHA.120.017963","article-title":"Association of isolated diastolic hypertension based on the cutoff value in the 2017 American College of Cardiology\/American Heart Association blood pressure guidelines with subsequent cardiovascular events in the general population","volume":"9","author":"Kaneko","year":"2020","journal-title":"J Am Heart Assoc"},{"key":"2022102020072900900_zwac193-B7","doi-asserted-by":"crossref","first-page":"846","DOI":"10.5551\/jat.GL2017","article-title":"Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017","volume":"25","author":"Kinoshita","year":"2018","journal-title":"J Atheroscler Thromb"},{"key":"2022102020072900900_zwac193-B8","doi-asserted-by":"crossref","first-page":"3021","DOI":"10.1093\/eurheartj\/ehy339","article-title":"2018 ESC\/ESH guidelines for the management of arterial hypertension","volume":"39","author":"Williams","year":"2018","journal-title":"Eur Heart J"},{"key":"2022102020072900900_zwac193-B9","doi-asserted-by":"crossref","first-page":"e58","DOI":"10.1161\/HYP.0000000000000195","article-title":"Management of stage 1 hypertension in adults with a low 10-year risk for cardiovascular disease: filling a guidance gap: a scientific statement from the American heart association","volume":"77","author":"Jones","year":"2021","journal-title":"Hypertension"},{"key":"2022102020072900900_zwac193-B10","doi-asserted-by":"crossref","first-page":"k2357","DOI":"10.1136\/bmj.k2357","article-title":"Impact of 2017 ACC\/AHA guidelines on prevalence of hypertension and eligibility for antihypertensive treatment in United States and China: nationally representative cross sectional study","volume":"362","author":"Khera","year":"2018","journal-title":"BMJ"},{"key":"2022102020072900900_zwac193-B11","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1161\/CIRCULATIONAHA.117.032582","article-title":"Potential US population impact of the 2017 ACC\/AHA high blood pressure guideline","volume":"137","author":"Muntner","year":"2018","journal-title":"Circulation"},{"key":"2022102020072900900_zwac193-B12","doi-asserted-by":"crossref","first-page":"e004248","DOI":"10.1161\/JAHA.116.004248","article-title":"Effectiveness of chlorthalidone plus amiloride for the prevention of hypertension: the PREVER-prevention randomized clinical trial","volume":"5","author":"Fuchs","year":"2016","journal-title":"J Am Heart Assoc"},{"key":"2022102020072900900_zwac193-B13","doi-asserted-by":"crossref","first-page":"1685","DOI":"10.1056\/NEJMoa060838","article-title":"Feasibility of treating prehypertension with an angiotensin-receptor blocker","volume":"354","author":"Julius","year":"2006","journal-title":"N Engl J Med"},{"key":"2022102020072900900_zwac193-B14","doi-asserted-by":"crossref","first-page":"1487","DOI":"10.1097\/HJH.0b013e3282ff8864","article-title":"The PHARAO study: prevention of hypertension with the angiotensin-converting enzyme inhibitor ramipril in patients with high-normal blood pressure: a prospective, randomized, controlled prevention trial of the German Hypertension League","volume":"26","author":"Luders","year":"2008","journal-title":"J Hypertens"},{"key":"2022102020072900900_zwac193-B15","doi-asserted-by":"crossref","first-page":"1201","DOI":"10.1016\/j.jacc.2018.06.056","article-title":"Long-term cardiovascular risk associated with stage 1 hypertension defined by the 2017 ACC\/AHA hypertension guideline","volume":"72","author":"Qi","year":"2018","journal-title":"J Am Coll Cardiol"},{"key":"2022102020072900900_zwac193-B16","doi-asserted-by":"crossref","first-page":"2103","DOI":"10.1056\/NEJMoa1511939","article-title":"A randomized trial of intensive versus standard blood-pressure control","volume":"373","author":"Group","year":"2015","journal-title":"N Engl J Med"},{"key":"2022102020072900900_zwac193-B17","doi-asserted-by":"crossref","first-page":"1268","DOI":"10.1056\/NEJMoa2111437","article-title":"Trial of intensive blood-pressure control in older patients with hypertension","volume":"385","author":"Zhang","year":"2021","journal-title":"N Engl J Med"},{"key":"2022102020072900900_zwac193-B18","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1016\/j.ijcard.2016.07.222","article-title":"Association between mortality and incidence rates of coronary heart disease and stroke: the Japan Public Health Center-based prospective (JPHC) study","volume":"222","author":"Saito","year":"2016","journal-title":"Int J Cardiol"},{"key":"2022102020072900900_zwac193-B19","doi-asserted-by":"crossref","first-page":"1892","DOI":"10.1161\/CIRCULATIONAHA.108.823112","article-title":"Four blood pressure indexes and the risk of stroke and myocardial infarction in Japanese men and women: a meta-analysis of 16 cohort studies","volume":"119","author":"Miura","year":"2009","journal-title":"Circulation"}],"container-title":["European Journal of Preventive Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/eurjpc\/advance-article-pdf\/doi\/10.1093\/eurjpc\/zwac193\/46055240\/zwac193.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eurjpc\/article-pdf\/29\/14\/1921\/46582764\/zwac193.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eurjpc\/article-pdf\/29\/14\/1921\/46582764\/zwac193.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,10,20]],"date-time":"2022-10-20T20:08:24Z","timestamp":1666296504000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/eurjpc\/article\/29\/14\/1921\/6679611"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,1]]},"references-count":19,"journal-issue":{"issue":"14","published-online":{"date-parts":[[2022,9,1]]},"published-print":{"date-parts":[[2022,10,20]]}},"URL":"https:\/\/doi.org\/10.1093\/eurjpc\/zwac193","relation":{},"ISSN":["2047-4873","2047-4881"],"issn-type":[{"value":"2047-4873","type":"print"},{"value":"2047-4881","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,10,1]]},"published":{"date-parts":[[2022,9,1]]}}}