Systolic blood pressure, isolated systolic hypertension and risk of coronary heart disease, strokes, cardiovascular disease and all-cause mortality in the middle-aged population

1998 ◽  
Vol 16 (5) ◽  
pp. 577-583 ◽  
Author(s):  
Riitta Antikainen ◽  
Pekka Jousilahti ◽  
Jaakko Tuomilehto
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Systolic Blood Pressure ◽  
Systolic Hypertension ◽  
Isolated Systolic Hypertension ◽  
Middle Aged ◽  
Aged Population ◽  
All Cause Mortality

scholarly journals Association of Cumulative Systolic Blood Pressure With Long-Term Risk of Cardiovascular Disease and Healthy Longevity

Hypertension ◽  
2020 ◽  
Author(s):  
Orna Reges ◽  
Hongyan Ning ◽  
John T. Wilkins ◽  
Colin O. Wu ◽  
Xin Tian ◽  
...  
Keyword(s):  
Heart Failure ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Coronary Heart Disease ◽  
Risk Factor ◽  
Heart Disease ◽  
Systolic Blood Pressure ◽  
Healthy Longevity ◽  
All Cause Mortality

Hypertension is a major risk factor for cardiovascular disease (CVD), but previous studies have mostly been limited to a single exam, a single cohort, a short follow-up period, or a limited number of outcomes. This study aimed to assess the association of 10-year cumulative systolic blood pressure (BP) in middle age with long-term risk of any CVD, coronary heart disease, stroke, heart failure, all-cause mortality, and healthy longevity. Individuals (11 502) from 5 racially/ethnically diverse US community-based cohorts were included in this study once they met all the inclusion criteria: ≥10 year of observation in the included cohort, aged 45 to 60 years, free of CVD, and had ≥3 visits with BP exams over the preceding 10 years. For each participant, systolic BP level was predicted for each year of the 10-year prior inclusion, based on the available exams (median of 4.0; spread over, 9.1 [range, 7.2–10] years). Lower 10-year cumulative systolic BP was associated with 4.1 years longer survival and 5.4 years later onset of CVD, resulting in living longer life with a shorter period with morbidity. Models adjusted for sociodemographic characteristics, cardiovascular risk factors, and index systolic BP demonstrated associations of 10-year cumulative systolic BP (per 130 mm Hg×year change, the threshold for stage-1 hypertension) with CVD (hazard ratio [HR], 1.28 [95% CI, 1.20–1.36]), coronary heart disease (HR, 1.29 [95% CI, 1.19–1.40]), stroke (HR, 1.33 [95% CI, 1.20–1.47]), heart failure (HR, 1.12 [95% CI, 1.02–1.23]), and all-cause mortality (HR, 1.21 [95% CI, 1.14–1.29]). These findings emphasize the importance of 10-year cumulative systolic BP as a risk factor to CVD, above and beyond current systolic BP.

scholarly journals SEVEN-YEAR INCREASE IN EXERCISE SYSTOLIC BLOOD PRESSURE AT 100W PREDICTS LONG-TERM RISK OF CORONARY HEART DISEASE IN HEALTHY MIDDLE-AGED MEN

2012 ◽  
Vol 59 (13) ◽  
pp. E1627
Author(s):  
Per Torger Skretteberg ◽  
Irene Grundvold ◽  
Sverre Kjeldsen ◽  
Knut Gjesdal ◽  
Knut Liestøl ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Systolic Blood Pressure ◽  
Middle Aged

P4346Religious education and midlife observance are associated with lower coronary heart disease (CHD) mortality 23 years later

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
S Eilat-Adar ◽  
U Goldbourt
Keyword(s):  
Blood Pressure ◽  
Body Mass Index ◽  
Socioeconomic Status ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Systolic Blood Pressure ◽  
Body Mass ◽  
Reference Group ◽  
Middle Aged

Abstract Objective To determine whether self-reported religiosity is associated with decreased coronary mortality risk in middle-aged men when rates are adjusted for known confounders. Design The Israeli Ischemic Heart Disease (IIHD) Project (n=10,232) was chosen by stratified sampling of civil servants and municipal male employees, men aged 40–65 in 1963. Subjects were seen upon enrollment (1963) and at two follow-up visits (1965 and 1968). Extent of religiosity according to belief and practice collected in 1965 on a scale from 1 to 5. Religiosity was defined as follow: (1) The most-strict observance of religious rules “Haredim”. (2) “Religious” (3) “Traditional” (4) “Secular” (5) The part of the latter who declared themselves to be “nonbelievers” were categorized as “agnostic”. Main outcome measure Coronary heart disease (CHD) death, determined from death certificates in 23 years of follow-up Results Among 9245 participants, 1098 died from CHD during 23 years follow up. Ever smoking, Body mass index (BMI) and socioeconomic status were significantly lower while age and diabetes were higher according to increasing religiosity. Religiosity was inversely related to CHD mortality. Demographic, anthropometric characteristics according to religion, and odds ratio (OR), 95% confidence interval (95% CI), for CHD mortality, (using agnostic as a reference group) are presented in table 1. Characteristics according to religion Religiosity Haredim (n=2103) Religious (n=1528) Traditional (n=1782) Secular (n=2085) Agnostic (n=1747) P for trend Age years (SD) 50.2 (6.9) 48.8 (6.6) 48.4 (6.7) 48.8 (6.6) 45.9 (6.8) <0.001 Ever smoking% 58.7 67.6 70.7 71.9 72.6 0.001 Systolic blood pressure (mmHg) 136 (21) 135 (20) 135 (21) 134 (20) 135 (20) 0.115 Diabetes (%) 9.8 11.1 8.3 8.8 6.5 <0.001 Socioeconomic status 2.2 (1.3) 2.3 (1.1) 2.7 (1.1) 2.7 (1.2) 3.1 (1.4) <0.001 BMI kg/m2 (SD) 22.5 (3.6) 25.9 (3.5) 25.9 (3.2) 25.6 (3.2) 25.4 (2.9) 0.028 Cholesterol (mg%) 201 (38) 207 (41) 208 (39) 214 (40) 218 (40) 0.001 Number of death (% category) 187 (8.9) 161 (10.5) 185 (10.4) 228 (10.9) 225 (12.9) <0.001 OR (95% CI)* 0.67 (0.53–0.85) 0.85 (0.67–1.08) 0.84 (0.67–1.05) 0.87 (0.71–1.08) 1 *Adjusted for age, cigarette smoking, systolic blood pressure, diabetes, socioeconomic status, body mass index and cholesterol. Conclusion Religiosity was associated with lower CHD death in employed middle aged Israeli men followed up prospectively for 23 years.

scholarly journals Seven-Year Increase in Exercise Systolic Blood Pressure at Moderate Workload Predicts Long-Term Risk of Coronary Heart Disease and Mortality in Healthy Middle-Aged Men

Hypertension ◽  
2013 ◽  
Vol 61 (5) ◽  
pp. 1134-1140 ◽  
Author(s):  
Per Torger Skretteberg ◽  
Irene Grundvold ◽  
Sverre E. Kjeldsen ◽  
Kristian Engeseth ◽  
Knut Liestøl ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Systolic Blood Pressure ◽  
Middle Aged

scholarly journals Understanding the consequences of education inequality on cardiovascular disease: mendelian randomisation study

BMJ ◽  
2019 ◽  
pp. l1855 ◽  
Author(s):  
Alice R Carter ◽  
Dipender Gill ◽  
Neil M Davies ◽  
Amy E Taylor ◽  
Taavi Tillmann ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Systolic Blood Pressure ◽  
Odds Ratio ◽  
Lower Risk ◽  
Smoking Behaviour ◽  
Mendelian Randomisation

AbstractObjectivesTo investigate the role of body mass index (BMI), systolic blood pressure, and smoking behaviour in explaining the effect of education on the risk of cardiovascular disease outcomes.DesignMendelian randomisation study.SettingUK Biobank and international genome-wide association study data.ParticipantsPredominantly participants of European ancestry.ExposureEducational attainment, BMI, systolic blood pressure, and smoking behaviour in observational analysis, and randomly allocated genetic variants to instrument these traits in mendelian randomisation.Main outcomes measureThe risk of coronary heart disease, stroke, myocardial infarction, and cardiovascular disease (all subtypes; all measured in odds ratio), and the degree to which this is mediated through BMI, systolic blood pressure, and smoking behaviour respectively.ResultsEach additional standard deviation of education (3.6 years) was associated with a 13% lower risk of coronary heart disease (odds ratio 0.86, 95% confidence interval 0.84 to 0.89) in observational analysis and a 37% lower risk (0.63, 0.60 to 0.67) in mendelian randomisation analysis. As a proportion of the total risk reduction, BMI was estimated to mediate 15% (95% confidence interval 13% to 17%) and 18% (14% to 23%) in the observational and mendelian randomisation estimates, respectively. Corresponding estimates were 11% (9% to 13%) and 21% (15% to 27%) for systolic blood pressure and 19% (15% to 22%) and 34% (17% to 50%) for smoking behaviour. All three risk factors combined were estimated to mediate 42% (36% to 48%) and 36% (5% to 68%) of the effect of education on coronary heart disease in observational and mendelian randomisation analyses, respectively. Similar results were obtained when investigating the risk of stroke, myocardial infarction, and cardiovascular disease.ConclusionsBMI, systolic blood pressure, and smoking behaviour mediate a substantial proportion of the protective effect of education on the risk of cardiovascular outcomes and intervening on these would lead to reductions in cases of cardiovascular disease attributable to lower levels of education. However, more than half of the protective effect of education remains unexplained and requires further investigation.

scholarly journals What explains the effect of education on cardiovascular disease? Applying Mendelian randomization to identify the consequences of education inequality

2018 ◽  
Author(s):  
Alice R Carter ◽  
Dipender Gill ◽  
Neil M Davies ◽  
Amy E Taylor ◽  
Taavi Tillmann ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Body Mass Index ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Systolic Blood Pressure ◽  
Body Mass ◽  
Mendelian Randomization

Key PointsQuestionWhat is the role of body mass index, systolic blood pressure and smoking in mediating the effect of education on cardiovascular disease risk?FindingWe find consistent evidence that body mass index, systolic blood pressure and smoking mediate the effect of education, explaining up to 18%, 27% and 33% respectively. Including all three risk factors in a model together explains around 40% of the effect of education.MeaningIntervening on body mass index, systolic blood pressure and smoking would lead to reductions in cases of CVD attributable to lower levels of education. Over half of the effect of education on risk of cardiovascular disease is not mediated through these risk factors.ImportanceLower levels of education are causally related to higher cardiovascular risk, but the extent to which this is driven by modifiable risk factors also associated with education is unknown.ObjectiveTo investigate the role of body mass index, systolic blood pressure and smoking in explaining the effect of education on risk of cardiovascular disease outcomes.DesignMultivariable regression analysis of observational data and Mendelian randomization (MR) analysis of genetic data.SettingUK Biobank and international genome-wide association study consortia.ParticipantsPredominantly individuals of European ancestry.Main outcomes and measuresThe effects of education (per 1-standard deviation increase, equivalent to 3.6 years) on coronary heart disease, cardiovascular disease (all subtypes), myocardial infarction and stroke risk (all measured in odds ratio, OR), and the degree to which this is mediated through body mass index, systolic blood pressure and smoking.ResultsEach additional standard deviation of education associated with 13% lower risk of coronary heart disease (OR 0.87, 95% confidence interval [CI] 0.84 to 0.89) in observational analysis and 37% lower risk (OR 0.63, 95% CI 0.60 to 0.67) in Mendelian randomization analysis. As a proportion of the total risk reduction, body mass index mediated 15% (95% CI 13% to 17%) and 18% (95% CI 14% to 23%) in the observational and Mendelian randomization estimates, respectively. Corresponding estimates for systolic blood pressure were 11% (95% CI 9% to 13%) and 21% (95% CI 15% to 27%), and for smoking, 19% (15% to 22%) and 33% (95% CI 17% to 49%). All three risk factors combined mediated 42% (95% CI 36% to 48%) and 36% (95 % CI 16% to 63%) of the effect of education on coronary heart disease in observational and Mendelian randomization respectively. Similar results were obtained when investigating risk of stroke, myocardial infarction and all-cause cardiovascular disease.Conclusions and relevanceBMI, SBP and smoking mediate a substantial proportion of the protective effect of education on risk of cardiovascular outcomes and intervening on these would lead to reductions in cases of CVD attributable to lower levels of education. However, more than half of the protective effect of education remains unexplained and requires further investigation.

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