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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.
Tuesday,2013-10-01 09:59 America/Los_Angeles — poolea2
| Title | 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. |
| Publication Type | Journal Article |
| Year of Publication | 2012 |
| Authors | Allen, N, Berry, JD, Ning, H, Van Horn, L, Dyer, A, Lloyd-Jones, DM |
| Journal | Circulation |
| Volume | 125 |
| Issue | 1 |
| Pagination | 37-44 |
| Date Published | 2012 Jan 03 |
| ISSN | 1524-4539 |
| Keywords | Aged, Aged, 80 and over, Blood Pressure, Cardiovascular Diseases, Cohort Studies, Female, Follow-Up Studies, Humans, Hypertension, Life Tables, Longitudinal Studies, Male, Middle Aged, Risk Factors |
| Abstract | <p><b>BACKGROUND: </b>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.</p><p><b>METHODS AND RESULTS: </b>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.</p><p><b>CONCLUSIONS: </b>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.</p> |
| DOI | 10.1161/CIRCULATIONAHA.110.002774 |
| Alternate Journal | Circulation |
| PubMed ID | 22184621 |
| PubMed Central ID | PMC3310202 |
| Grant List | U01 HL080295 / HL / NHLBI NIH HHS / United States N01 HC015103 / HC / NHLBI NIH HHS / United States N01HC55222 / HL / NHLBI NIH HHS / United States N01HC85086 / HL / NHLBI NIH HHS / United States T32 HL 069771-07 / HL / NHLBI NIH HHS / United States T32 HL069771 / HL / NHLBI NIH HHS / United States T32 HL069771-07 / HL / NHLBI NIH HHS / United States N01HC75150 / HL / NHLBI NIH HHS / United States R21 HL085375 / HL / NHLBI NIH HHS / United States N01HC85079 / HL / NHLBI NIH HHS / United States N01 HC045133 / HC / NHLBI NIH HHS / United States N01 HC035129 / HC / NHLBI NIH HHS / United States N01WH22110 / WH / WHI NIH HHS / United States R21 HL085375-02 / HL / NHLBI NIH HHS / United States |