WESTPORT, CT (Reuters Health) - Middle-aged men with systolic hypertension appear to be at higher risk of death when their diastolic blood pressure is normal than when their diastolic blood pressure is mildly or moderately increased. However, women appear to be at increased risk when both the systolic and diastolic blood pressures are elevated, according to a report by French researchers.

Dr. Athanase Benetos, from the Centre d'Investigations Preventives et Cliniques, Paris, and colleagues collected data on 77,023 men and 48,480 women 40 to 70 years of age. At baseline, these subjects had no major cardiovascular disease and were not on antihypertensive therapy, according to the report in the Journal of the American College of Cardiology for January. The researchers assessed mortality in this cohort over an 8- to 12-year period.

For both men and women, the investigators found that cardiovascular mortality increased as systolic blood pressure increased. After adjusting for age and systolic blood pressure, they noted that for subjects with normal systolic pressure, diastolic pressure did not influence cardiovascular mortality.

Dr. Benetos' team detected a U-shaped curve relationship between cardiovascular mortality and diastolic pressure in men with systolic hypertension. In this group, the lowest mortality rates were seen among men whose diastolic pressure was 90 to 99 mm Hg. However, there was a 73% increase in mortality for men whose diastolic pressure was less than 90 mm Hg, and a 65% increase in mortality when the diastolic pressure was 110 mm Hg or greater, according to the report.

Additionally, among women with systolic hypertension, diastolic blood pressure was "positively correlated with cardiovascular mortality," the researchers note.

"In middle-aged subjects, classification of cardiovascular risk according to diastolic blood pressure levels should take into account gender, especially when systolic blood pressure levels are elevated," Dr. Benetos' group concludes.

From Reutershealth.com