Document Detail


Impact of blood pressure and blood pressure change during middle age on the remaining lifetime risk for cardiovascular disease: the cardiovascular lifetime risk pooling project.
MedLine Citation:
PMID:  22184621     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Prior estimates of lifetime risk (LTR) for cardiovascular disease (CVD) examined the impact of blood pressure (BP) at the index age and did not account for changes in BP over time. We examined how changes in BP during middle age affect LTR for CVD, coronary heart disease, and stroke.
METHODS AND RESULTS: Data from 7 diverse US cohort studies were pooled. Remaining LTRs for CVD, coronary heart disease, and stroke were estimated for white and black men and women with death free of CVD as a competing event. LTRs for CVD by BP strata and by changes in BP over an average of 14 years were estimated. Starting at 55 years of age, we followed up 61 585 men and women for 700 000 person-years. LTR for CVD was 52.5% (95% confidence interval, 51.3-53.7) for men and 39.9% (95% confidence interval, 38.7-41.0) for women. LTR for CVD was higher for blacks and increased with increasing BP at index age. Individuals who maintained or decreased their BP to normal levels had the lowest remaining LTR for CVD, 22% to 41%, compared with individuals who had or developed hypertension by 55 years of age, 42% to 69%, suggesting a dose-response effect for the length of time at high BP levels.
CONCLUSIONS: Individuals who experience increases or decreases in BP in middle age have associated higher and lower remaining LTR for CVD. Prevention efforts should continue to emphasize the importance of lowering BP and avoiding or delaying the incidence of hypertension to reduce the LTR for CVD.
Authors:
Norrina Allen; Jarett D Berry; Hongyan Ning; Linda Van Horn; Alan Dyer; Donald M Lloyd-Jones
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, P.H.S.     Date:  2011-12-19
Journal Detail:
Title:  Circulation     Volume:  125     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-01-04     Completed Date:  2012-02-24     Revised Date:  2013-06-26    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  37-44     Citation Subset:  AIM; IM    
Affiliation:
Department of Preventive Medicine and Division of Cardiology, Feinberg School of Medicine, Northwestern University, 680 N Lake Shore Dr, Ste 1102, Chicago, IL 60611, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Blood Pressure* / physiology
Cardiovascular Diseases / epidemiology*,  etiology,  physiopathology
Cohort Studies
Female
Follow-Up Studies
Humans
Hypertension / complications,  epidemiology*,  physiopathology
Life Tables*
Longitudinal Studies
Male
Middle Aged
Risk Factors
Grant Support
ID/Acronym/Agency:
R21 HL085375/HL/NHLBI NIH HHS; R21 HL085375-02/HL/NHLBI NIH HHS; T32 HL 069771-07/HL/NHLBI NIH HHS; T32 HL069771/HL/NHLBI NIH HHS; T32 HL069771-07/HL/NHLBI NIH HHS; U01 HL080295/HL/NHLBI NIH HHS
Comments/Corrections

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