Systolic blood pressure at age 40 and 30-year stroke risk in men and women.

Autor:	Walle-Hansen MM; Department of Medical Research, Vestre Viken Hospital Trust, Bærum Hospital, Drammen, Norway marte.meyer.walle-hansen@vestreviken.no.; Institute of Clinical Medicine, University of Oslo Faculty of Medicine, Oslo, Norway., Hagberg G; Institute of Clinical Medicine, University of Oslo Faculty of Medicine, Oslo, Norway.; Stroke Unit, Department of Neurology, Oslo University Hospital, Oslo, Norway., Myrstad M; Department of Medical Research, Vestre Viken Hospital Trust, Bærum Hospital, Drammen, Norway.; Institute of Clinical Medicine, University of Oslo Faculty of Medicine, Oslo, Norway., Berge T; Department of Medical Research, Vestre Viken Hospital Trust, Bærum Hospital, Drammen, Norway.; Department of Internal Medicine, Vestre Viken Hospital Trust, Bærum Hospital, Drammen, Norway., Vigen T; Department of Neurology, Division of Medicine, Akershus University Hospital, Lorenskog, Norway., Ihle-Hansen H; Department of Medical Research, Vestre Viken Hospital Trust, Bærum Hospital, Drammen, Norway.; Stroke Unit, Department of Neurology, Oslo University Hospital, Oslo, Norway., Thommessen B; Department of Neurology, Division of Medicine, Akershus University Hospital, Lorenskog, Norway., Ariansen I; Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Norway., Lyngbakken MN; Department of Cardiology, Division of Medicine, Akershus University Hospital, Lorenskog, Norway.; K.G. Jebsen Center for Cardiac Biomarkers, Institute for Clinical Medicine, University of Oslo, Oslo, Norway., Røsjø H; K.G. Jebsen Center for Cardiac Biomarkers, Institute for Clinical Medicine, University of Oslo, Oslo, Norway.; Akershus Clinical Research Center, Division of Research and Innovation, Akershus University Hospital, Lorenskog, Norway., Rønning OM; Institute of Clinical Medicine, University of Oslo Faculty of Medicine, Oslo, Norway.; Department of Neurology, Division of Medicine, Akershus University Hospital, Lorenskog, Norway., Tveit A; Department of Medical Research, Vestre Viken Hospital Trust, Bærum Hospital, Drammen, Norway.; Institute of Clinical Medicine, University of Oslo Faculty of Medicine, Oslo, Norway., Ihle-Hansen H; Department of Medical Research, Vestre Viken Hospital Trust, Bærum Hospital, Drammen, Norway.; Institute of Clinical Medicine, University of Oslo Faculty of Medicine, Oslo, Norway.
Jazyk:	angličtina
Zdroj:	Open heart [Open Heart] 2024 Aug 22; Vol. 11 (2). Date of Electronic Publication: 2024 Aug 22.
DOI:	10.1136/openhrt-2024-002805
Abstrakt:	Background: American and European guidelines define hypertension differently and are sex agnostic. Our aim was to assess the impact of different hypertension thresholds at the age of 40 on 30-year stroke risk and to examine sex differences. Methods: We included 2608 stroke-free individuals from the Akershus Cardiac Examination 1950 Study, a Norwegian regional study conducted in 2012-2015 of the 1950 birth cohort, who had previously participated in the Age 40 Program, a nationwide health examination study conducted in 1990-1993. We categorised participants by systolic blood pressure (SBP) at age 40 (<120 mm Hg (reference), 120-129 mm Hg, 130-139 mm Hg and ≥140 mm Hg) and compared stroke risk using Cox proportional hazard regressions adjusted for age, sex, smoking, cholesterol, physical activity, obesity and education. Fatal and non-fatal strokes were obtained from the Norwegian Cardiovascular Disease Registry from 1 January 2012 to 31 December 2020, in addition to self-reported strokes. Results: The mean age was 40.1±0.3 years (50.4% women) and mean SBP was 128.3±13.5 mm Hg (mean±SD). Stroke occurred in 115 (4.4%) individuals (32 (28%) women and 83 (72%) men) during 29.4±2.9 years of follow-up. SBP between 130 and 139 mm Hg was not associated with stroke (adjusted HR 1.71, 95% CI 0.87 to 3.36) while SBP ≥140 mm Hg was associated with increased stroke risk (adjusted HR 3.11, 95% CI 1.62 to 6.00). The adjusted HR of stroke was 4.32 (95% CI 1.66 to 11.26) for women and 2.66 (95% CI 1.03 to 6.89) for men, with non-significant sex interactions. Conclusions: SBP ≥140 mm Hg was significantly associated with 30-year stroke risk in both sexes. A small subgroup of women had SBP ≥140 mm Hg and systolic hypertension was a strong risk factor for stroke in these women. Trial Registration Number: NCT01555411. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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