{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:55:00Z","timestamp":1787018100936,"version":"build-2736575974"},"reference-count":39,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"19","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2020,10,6]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">The 2017 American College of Cardiology (ACC)\/American Heart Association (AHA) guidelines lowered the threshold of blood pressure (BP) for hypertension to 130\/80\u00a0mm\u00a0Hg. However, the clinical significance of isolated diastolic hypertension (IDH) according to the cutoff value of the 2017 ACC\/AHA guidelines was uncertain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">We analyzed the claims database of Japan Medical Data Center (a nationwide epidemiological database). We excluded individuals who were aged &lt;20\u00a0years, had systolic hypertension, were taking antihypertensive medication, or had prevalent cardiovascular disease, and studied 1\u00a0746\u00a0493 individuals (mean age, 42.9\u00b110.7\u00a0years; 961\u00a0097 men [55.0%]). The average observational period was 1107\u00b1855\u00a0days. Stage 1 IDH, defined as diastolic BP 80 to 89\u00a0mm\u00a0Hg, and stage 2 IDH, defined as diastolic BP \u226590\u00a0mm\u00a0Hg, were found in 230\u00a0513 (13.2%) and 16\u00a0159 (0.9%) individuals, respectively. Compared with individuals with normal diastolic BP, individuals with stage 1 and stage 2 IDH were older and more likely to be men. Prevalence of classic risk factors was higher in patients with IDH. Kaplan\u2013Meier curves showed that stage 1 and stage 2 IDH were associated with a higher incidence of cardiovascular events, defined as myocardial infarction, angina pectoris, and stroke. Multivariable analysis showed that stage 1 (hazard ratio [HR], 1.17) and stage 2 (HR, 1.28) IDH were independently associated with a higher incidence of cardiovascular events. Subgroup analyses showed that the association of IDH with cardiovascular events was seen irrespective of age and sex.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">The analysis of a nationwide epidemiological database showed that IDH based on the cutoff value in the 2017 ACC\/AHA BP guidelines was associated with an elevated risk of subsequent cardiovascular events.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.120.017963","type":"journal-article","created":{"date-parts":[[2020,9,30]],"date-time":"2020-09-30T04:55:03Z","timestamp":1601441703000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":68,"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"],"prefix":"10.1161","volume":"9","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 Japan"},{"name":"The Department of Advanced Cardiology The University of Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hidetaka","family":"Itoh","sequence":"additional","affiliation":[{"name":"The Department of Cardiovascular Medicine The University of Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haruki","family":"Yotsumoto","sequence":"additional","affiliation":[{"name":"The Department of Cardiovascular Medicine The University of Tokyo 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