Age and Sex Disparities in Hypertension Control: The Multi-Ethnic Study of Atherosclerosis (MESA)

Introduction: Blood pressure (BP) control may decline with age and degree of decline may differ by sex. Methods: The Multi-Ethnic Study of Atherosclerosis (MESA) recruited 6814 men and women, age 45 to 84 years, from six communities in the U.S. during 2000-2002 and follow-up exams occurred every two years for a total of 6 exams from 2000-2016. We assessed the association of age and sex with hypertension control using MESA data among participants receiving treatment for hypertension at any of the first five exams At each exam, resting BP was measured in triplicate at 1-minute intervals using an automated oscillometric device; we used the mean of last two measurements. Hypertension control was defined as BP < 140/90 mmHg among adults with treated hypertension. Mixed-effects models were used to examine the association of sex with BP control by age group (45-64, 65-84, 85+ yrs) while accounting for the clustering within sites and intra-individual correlation and adjusting for demographics, co-morbidities, smoking, alcohol use, and education. Results: Among the 2,017 adults receiving treatment for hypertension (63.1% controlled), the mean age at exam 1 was 64.0 (9.1) yrs, 43.3% male; race/ethnicity was 33.5% White, 9.2% Chinese, 37.2% Black and 20.1% Hispanic. There was a significant interaction of sex*age group (P < 0.001) in mixed-effects models after adjustment for all covariates. The adjusted probability of BP control was then calculated for each sex and age group. Among women, the probability of BP control declined from 74.6% (95% CI 70.8%, 78.5%) for age 45-64 yrs to 55.9% (50.0%, 61.8%) for age 85+ yrs. Among men, probability of BP control declined from 74.0% (70.0%, 78.0%) for age 45-64 yrs to 70.6% (65.7%, 75.5%) for age 85+ yrs. The figure shows the probability of hypertension control by sex and age at a given exam. Conclusion: Hypertension control differs by sex. Interventions are needed to address age-related sex disparities in hypertension control.

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Race/ethnic and sex disparities in the non-alcoholic fatty liver disease-abdominal aortic calcification association: The Multi-Ethnic Study of Atherosclerosis

Atherosclerosis ◽

10.1016/j.atherosclerosis.2016.11.021 ◽

2017 ◽

Vol 258 ◽

pp. 89-96 ◽

Cited By ~ 7

Author(s):

Rosemay A. Remigio-Baker ◽

Matthew A. Allison ◽

Nketi I. Forbang ◽

Rohit Loomba ◽

Cheryl A.M. Anderson ◽

...

Keyword(s):

Liver Disease ◽

Fatty Liver ◽

Fatty Liver Disease ◽

Aortic Calcification ◽

Abdominal Aortic Calcification ◽

Alcoholic Fatty Liver ◽

Ethnic Study ◽

Abdominal Aortic ◽

Sex Disparities ◽

Alcoholic Fatty Liver Disease

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Age and Sex Disparities in Adherence to CPAP

CHEST Journal ◽

10.1016/j.chest.2020.07.017 ◽

2021 ◽

Vol 159 (1) ◽

pp. 382-389 ◽

Cited By ~ 1

Author(s):

Sanjay R. Patel ◽

Jessie P. Bakker ◽

Christy J. Stitt ◽

Mark S. Aloia ◽

S. Mehdi Nouraie

Keyword(s):

Sex Disparities ◽

Age And Sex

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Racial/ethnic, age and sex disparities in leukemia survival among adults in the United States during 1973-2014 period

PLoS ONE ◽

10.1371/journal.pone.0220864 ◽

2019 ◽

Vol 14 (8) ◽

pp. e0220864 ◽

Cited By ~ 2

Author(s):

Ovie Utuama ◽

Fahad Mukhtar ◽

Yen Thi-Hai Pham ◽

Bashir Dabo ◽

Priyashi Manani ◽

...

Keyword(s):

United States ◽

The United States ◽

Sex Disparities ◽

Racial Ethnic ◽

Age And Sex

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Abstract 18130: Quantitative Heart Measures Are More Predictive of 1-Year Mortality Than Weight-Based Donor-Recipient Matching in Heart Transplantation

Circulation ◽

10.1161/circ.130.suppl_2.18130 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Ziad Taimeh ◽

Khalil Murad ◽

Monica Colvin ◽

Sue Duval ◽

Cindy Martin ◽

...

Keyword(s):

Heart Transplantation ◽

Mathematical Models ◽

Mortality Rates ◽

Cardiac Volume ◽

Ethnic Study ◽

End Diastolic Volume ◽

Ventricular Mass ◽

The Impact ◽

Age And Sex ◽

United Network

Introduction and hypothesis: Donor-recipient matching in heart transplantation (HT) is heavily dependent on weight. The limited pool of donor hearts mandates efforts to expand that pool without compromising outcomes. We evaluated the impact of matching based on quantitative heart measures (QHMs) on 1-year survival after HT. Methods: Data from the United Network for Organ Sharing (UNOS) registry was used to calculate QHMs of both donors and recipients of HT. QHM uses validated mathematical models derived from the Multi-Ethnic Study of Atherosclerosis (MESA) cohort based on height, weight, age, and sex to estimate total ventricular mass (TVM), total ventricular end-diastolic volume (TVV), and total cardiac volume (TCV). The matching level of each donor-recipient pair was assessed for each QHM; matched ±25%, undersized and oversized. Association between matching level (by weight, and by each QHM) and 1-year mortality rates were then analyzed. Results: We identified a total of 37,265 donor-recipient pairs between 1987 and 2013. Matching by weight did not have any 1-year mortality (p=0.43) benefit. Under-sizing or over-sizing by TCV had significantly higher 1-year mortality (p<0.001). Over-sizing by either TVM or TVV had significantly higher 1-year mortality (p<0.001, p=0.024, respectively) (Table and Figure). Conclusions: In HT, donor-recipient matching by QHMs derived from height, weight, age, and sex may offer advantages for making decisions about organ suitability over a weight-based algorithm.

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