Document Detail


Population heterogeneity in trajectories of midlife blood pressure.
MedLine Citation:
PMID:  22249241     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: We investigated whether there are subgroups with different underlying (latent) trajectories of midlife systolic blood pressure (BP), diastolic BP, and pulse pressure in a UK cohort.
METHODS: Data are from 1840 men and 1819 women with BP measured at ages 36, 43, and 53 years. We used unconditional growth mixture models to test for the presence of latent trajectory classes. Extracted classes were described in terms of a number of known lifetime risk factors, and linked to the risk of undiagnosed angina (Rose questionnaire) at age 53 years.
RESULTS: In both sexes for systolic BP, diastolic BP, and pulse pressure, there was a large "normative" class (>90% of the sample) characterized by gentle annual increases (eg, an increase in male systolic BP of 0.9 mm Hg/year [95% confidence interval = 0.9 to 1.0]), with a smaller class for whom the rate of increase was high (eg, an increase in male systolic BP of 3.1 mm Hg/year [2.8 to 3.4]). In women, there was an additional class for whom BP was high at age 36 and remained high. Persons in the "normative" classes were, on average, heavier at birth and taller at age 7 years, had a lower midlife body mass index, and were less likely to be on antihypertensive medication compared with those in other classes. Among those with no diagnosed cardiovascular disease, those in the classes with more strongly increasing systolic BP and pulse pressure were at greatest risk of angina.
CONCLUSION: Our study suggests that in midlife the majority of the population have a gentle underlying increase in BP, but that there also exists an important subgroup in whom BP increases much more markedly. These classes may be useful for identifying those most at risk for cardiovascular disease.
Authors:
Andrew K Wills; Debbie A Lawlor; Graciela Muniz-Terrera; Fiona Matthews; Rachel Cooper; Arjun K Ghosh; Diana Kuh; Rebecca Hardy;
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Epidemiology (Cambridge, Mass.)     Volume:  23     ISSN:  1531-5487     ISO Abbreviation:  Epidemiology     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-02-09     Completed Date:  2012-05-25     Revised Date:  2014-02-20    
Medline Journal Info:
Nlm Unique ID:  9009644     Medline TA:  Epidemiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  203-11     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Age Factors
Angina Pectoris / physiopathology
Blood Pressure / physiology*
Cardiovascular Diseases / physiopathology
Female
Great Britain / epidemiology
Humans
Hypertension / epidemiology,  physiopathology
Linear Models
Male
Middle Aged
Reference Values
Risk Factors
Sex Factors
Grant Support
ID/Acronym/Agency:
MC_U105292687//Medical Research Council; MC_U123092721//Medical Research Council; MC_UP_A620_1014//Medical Research Council; MC_UP_A620_1015//Medical Research Council; U.1052.00.013.00001//Medical Research Council; U.1052.00.013.00003//Medical Research Council; U.1230.00.004.00001.01(92721)//Medical Research Council
Investigator
Investigator/Affiliation:
Avan Ahie Sayer / ; Eleni Bakra / ; Michaela Benzeval /
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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