Blood pressure trajectories in relation to cardiovascular mortality : The Rancho Bernardo Study

Autor: Johanna M. Geleijnse, S.M.A.J. Tielemans, Elizabeth Barrett-Connor, Gail A. Laughlin, Daan Kromhout, Hendriek C. Boshuizen
Jazyk: angličtina
Rok vydání: 2017
Předmět:
Gerontology
Adult
Male
Time Factors
Nutrition and Disease
Blood Pressure
030204 cardiovascular system & hematology
Risk Assessment
California
Older population
03 medical and health sciences
0302 clinical medicine
Risk Factors
Diabetes mellitus
Cause of Death
Voeding en Ziekte
Internal Medicine
medicine
Humans
Life Science
030212 general & internal medicine
Prospective Studies
cardiovascular diseases
Prospective cohort study
Antihypertensive Agents
Cardiovascular mortality
Cause of death
Aged
Proportional Hazards Models
VLAG
Human Nutrition & Health
Proportional hazards model
business.industry
Humane Voeding & Gezondheid
Middle Aged
medicine.disease
Blood pressure
Treatment Outcome
Hypertension
Disease Progression
Linear Models
Female
Risk assessment
business
Demography
circulatory and respiratory physiology
Zdroj: Journal of Human Hypertension 31 (2017)
Journal of Human Hypertension, 31, 515-519
ISSN: 0950-9240
Popis: The added value of blood pressure (BP) trajectories for predicting cardiovascular disease (CVD) is currently unknown. We investigated the association of systolic BP (SBP) trajectories with CVD and all-cause mortality and compared these associations with those of average SBP, taking antihypertensive medication into account. Data from 762 participants of the Rancho Bernardo Study were used. SBP from five examinations (maximum) from 1984 to 2002 was used; mortality data were obtained from 2002 to 2013. SBP trajectories were derived using group-based trajectory modelling. Cox proportional hazards analysis was used to investigate associations of trajectories and average SBP with CVD and all-cause mortality, adjusted for age, sex, cholesterol, smoking, diabetes and antihypertensive medication. Mean baseline age was 65.7 years, and 67% were women. Four trajectories were identified, in which mean SBP increased by 5–12 mm Hg during 10 years. The highest trajectories were associated with two to three times greater CVD mortality and 1.5 times greater all-cause mortality risk, compared with the lowest trajectory. Each 20 mmHg increment in average SBP was associated with 1.4 times greater CVD mortality risk and 1.2 times all-cause mortality risk. Associations were not modified by antihypertensive medication (P-interaction>0.10). SBP trajectories were not superior to average SBP in predicting CVD and all-cause mortality. In the general middle-aged and older population of the Rancho Bernardo study, SBP trajectories provided no added value to average SBP in predicting CVD and all-cause mortality. Long-term average SBP levels and trajectories were significant predictors of CVD and all-cause mortality, irrespective of prescribed antihypertensive medication (which in the 1980s–1990s mainly were diuretics and β-blockers).Journal of Human Hypertension advance online publication, 23 March 2017; doi:10.1038/jhh.2017.20.
Databáze: OpenAIRE
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