Disclosures: Plante reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
September 16, 2020
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New definition of hypertension less likely to be met with more ideal health behaviors

Disclosures: Plante reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
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Improving CV health by meeting components of Life’s Simple 7 may reduce the risk for incident hypertension when the lower hypertension threshold of 130/80 mm Hg is used, researchers found.

Timothy B. Plante
Source: David Seaver

“The clinical implication for practice is that the risk of high blood pressure drops with each point higher,” Timothy B. Plante, MD, MHS, professor in cardiovascular research at Larner College of Medicine at the University of Vermont, told Healio. “That means that a patient might be less receptive to quitting smoking but is interested in starting to get moderate-intensity exercise on a regular basis. That’s a 1-point increase right there. There are many options to improve cardiovascular health, and the recommendations can be customized to meet the patient where they are on that day.”

Each 1-point increase in Life's Simple 7 score, may reduce the risk for hypertension by 6%.

Data from REGARDS study

Researchers analyzed data from 2,930 participants (mean age, 61 years; 59% women; 23% Black) from the REGARDS study without hypertension at baseline from 2003 to 2007. Participants were followed up with a second visit from 2013 to 2016.

Hypertension in this study was defined in accordance with the 2017 American College of Cardiology/American Heart Association guideline: greater than 130 mm Hg systolic, greater than 80 mm Hg diastolic or use of antihypertensive medications.

Researchers scored each component of Life’s Simple 7 as poor (0 points), intermediate (1 point) or ideal (2 points). The total score was the sum of all components, with the highest score attainable of 14.

The outcome of interest was hypertension at the second study visit. Follow-up was conducted for a median of 9.4 years.

The median Life’s Simple 7 score was 9 for the overall population, 8 in Black men, 8 in Black women, 9 in white men and 9 in white women.

At the follow-up visit, 41% of participants developed hypertension. Each 1-point increase in the Life’s Simple 7 score resulted in a 6% lower risk for incident hypertension (RR per 1 point = 0.94; 95% CI, 0.92-0.96).

“This wasn’t a clinical trial, so we can’t say anything about cause and effect; that is, if we get people to improve their score, that their risk of developing high blood pressure will be lower,” Plante said in an interview. “We know from some clinical trials that weight loss, dietary improvements and increased exercise will lower blood pressure. In the end, this is further evidence that better cardiovascular health might play a key role in the development of high blood pressure and heart disease further down the line.”

Need for additional research

Plante told Healio that more research is needed in this area. “We need a clinical trial to show that improving [Life’s Simple 7] total score prevents high blood pressure,” he said. “We know from some trials that moving its components will lower blood pressure, but that’s not a ‘total’ view of cardiovascular risk.”

For more information:

Timothy B. Plante, MD, MHS, can be reached at timothy.plante@med.uvm.edu; Twitter: @tbplante.