Relationship between serum urate concentration and clinically evident incident gout: an individual participant data analysis

2018 ◽  
Vol 77 (7) ◽  
pp. 1048-1052 ◽  
Author(s):  
Nicola Dalbeth ◽  
Amanda Phipps-Green ◽  
Christopher Frampton ◽  
Tuhina Neogi ◽  
William J Taylor ◽  
...  
Keyword(s):  
Cumulative Incidence ◽  
Proportional Hazards ◽  
Serum Urate ◽  
Cox Proportional Hazards ◽  
Individual Participant Data ◽  
Baseline Serum ◽  
Atherosclerosis Risk In Communities ◽  
Heart Study ◽  
Individual Participant

ObjectivesTo provide estimates of the cumulative incidence of gout according to baseline serum urate.MethodsUsing individual participant data from four publicly available cohorts (Atherosclerosis Risk in Communities Study, Coronary Artery Risk Development in Young Adults Study, and both the Original and Offspring cohorts of the Framingham Heart Study), the cumulative incidence of clinically evident gout was calculated according to baseline serum urate category. Cox proportional hazards modelling was used to evaluate the relation of baseline urate categories to risk of incident gout.ResultsThis analysis included 18 889 participants who were gout-free at baseline, with mean (SD) 11.2 (4.2) years and 212 363 total patient-years of follow-up. The cumulative incidence at each time point varied according to baseline serum urate concentrations, with 15-year cumulative incidence (95% CI) ranging from 1.1% (0.9 to 1.4) for <6 mg/dL to 49% (31 to 67) for ≥10 mg/dL. Compared with baseline serum urate <6 mg/dL, the adjusted HR for baseline serum urate 6.0–6.9 mg/dL was 2.7, for 7.0–7.9 mg/dL was 6.6, for 8.0–8.9 mg/dL was 15, for 9.0–9.9 mg/dL was 30, and for ≥10 mg/dL was 64.ConclusionsSerum urate level is a strong non-linear concentration-dependent predictor of incident gout. Nonetheless, only about half of those with serum urate concentrations ≥10mg/dL develop clinically evident gout over 15 years, implying a role for prolonged hyperuricaemia and additional factors in the pathogenesis of gout.

scholarly journals Longitudinal development of incident gout from low-normal baseline serum urate concentrations: individual participant data analysis

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Philip C. Robinson ◽  
Christopher Frampton ◽  
Amanda Phipps-Green ◽  
Tuhina Neogi ◽  
Lisa Stamp ◽  
...  
Keyword(s):  
Risk Factor ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Elevated Serum ◽  
Serum Urate ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Baseline Serum ◽  
Atherosclerosis Risk In Communities ◽  
Hazards Model

Abstract Introduction Elevated serum urate (SU) concentration is the central risk factor for the development of gout. The aim of this study was to examine the incidence of gout in people with low and normal SU levels (< 7.00 mg/dL). Methods Longitudinal cohort data from the Atherosclerosis Risk in Communities Study (ARIC), Coronary Artery Risk Development in Young Adults Study (CARDIA), and both the Original and Offspring cohorts of the Framingham Heart Study (FHS) were used to determine incident gout by baseline SU over 3, 5, 10, 12 and 15 year periods. A Cox proportional hazards model with covariables of age, gender, ethnicity, and cohort was calculated to report the hazard ratios (HR) for incident gout. Results The incidence of gout at 15 years for a baseline SU < 4.00 mg/dL was 0.59%, 4.00–4.49 mg/dL was 1.28%, 4.50–4.99 mg/dL was 0.86%, 5.00–5.49 mg/dL was 0.94%, 5.50–5.99 mg/dL was 1.52%, 6.00–6.49 mg/dL was 2.91%, 6.50–6.99 mg/dL was 3.2%, and > 7.00 mg/dL was 12.2%. In an adjusted Cox proportional hazards model, compared to the referent baseline SU < 4.00 mg/dL, there was a non-significant increase in incident gout for baseline SU bands between 4.00–5.49 mg/dL, whereas incident gout was significantly increased for SU 5.50–5.99 mg/dL (HR 2.60), 6.00–6.49 mg/dL (HR 3.70), 6.50–6.99 mg/dL (HR 5.24) and > 7.00 mg/dL (HR 18.62). Conclusion A baseline SU of 5.50 mg/dL or more is a risk factor for development of gout over 15 years. However, incident gout does occur over time in a small proportion of people with lower baseline SU levels.

Abstract P322: Myocardial Contraction Fraction is an Independent Predictor of Incident Adverse Cardiovascular Events; The Framingham Heart Study

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Michael L Chuang ◽  
Philimon Gona ◽  
Connie W Tsao ◽  
Carol J Salton ◽  
Warren J Manning ◽  
...  
Keyword(s):  
Left Ventricle ◽  
Stroke Volume ◽  
Proportional Hazards ◽  
Independent Predictor ◽  
Myocardial Contraction ◽  
Cox Proportional Hazards ◽  
Community Dwelling ◽  
Heart Study ◽  
Myocardial Contraction Fraction

Introduction: Myocardial contraction fraction (MCF) is the ratio of left ventricular (LV) stroke volume to myocardial volume, and thus a measure of LV pumping capacity per unit of myocardium. We sought to determine whether MCF measured using current steady-state free precession (SSFP) cardiac magnetic resonance (CMR) sequences was an independent predictor of incident “hard” cardiovascular disease (CVD) events, defined by myocardial infarction (MI), stroke, unstable angina (UA), hospitalized heart failure (HF) or CVD death in a community dwelling cohort initially free of these CVD events. Methods: 1794 members of the Framingham Heart Study Offspring cohort (aged 65±9 years) underwent CMR between 2002-2006 using a 1.5-Tesla system with contiguous multislice SSFP cine imaging to encompass the left ventricle. MCF was determined from the cine images by a single observer blinded to participant characteristics. We tracked incident hard CVD events over median 6.5-year follow up and used Cox proportional hazards models (adjusted for age, sex, body mass index, systolic blood pressure, diabetes, dyslipidemia, smoking, treatment for hypertension) to determine hazard of hard CVD events per increment (0.10) of MCF. Results: MCF was determined in 1776 (99%) Offspring (835 men). Overall, MCF was greater in women (0.92±0.14 vs. 0.78±0.15 for men), p<0.0001. There were 60 incident hard CVD events during follow up. Incident hard events included 26 MI, 2 UA, 13 stroke, 14 hospitalized HF and 5 CVD deaths. Offspring experiencing an incident event had lower MCF (0.78±0.19 vs. 0.86±0.15 for those free of events), p=0.002. On MV-adjusted Cox proportional hazards analyses, a greater MCF was protective against hard CVD events, HR [95% confidence intervals] = 0.76 [0.63 - 0.93] per 0.10 increment of MCF. Conclusion: Over 6.5-year follow-up, greater MCF is protective against major adverse CVD events, even after adjustment for traditional CVD risk factors in a community dwelling cohort of middle-aged and older predominantly European-descended adults. Determination of MCF requires only knowledge of LV stroke volume and myocardial volume, both of which are routinely determined in a standard CMR examination of the left ventricle, and thus imposes no additional scan-time or analysis burden. While MCF may be clinically useful for prediction of risk for incident hard CVD events, its potential value in younger age groups and other ethnicities remains to be determined.

scholarly journals Bi-directional association between epilepsy and dementia

Neurology ◽  
2020 ◽  
Vol 95 (24) ◽  
pp. e3241-e3247 ◽  
Author(s):  
Maria Stefanidou ◽  
Alexa S. Beiser ◽  
Jayandra Jung Himali ◽  
Teng J. Peng ◽  
Orrin Devinsky ◽  
...  
Keyword(s):  
Proportional Hazards ◽  
Secondary Analysis ◽  
Cox Proportional Hazards ◽  
Dementia Risk ◽  
Incident Dementia ◽  
Heart Study ◽  
Allele Status ◽  
Ε4 Allele ◽  
Nested Case Control

ObjectiveTo assess the risk of incident epilepsy among participants with prevalent dementia and the risk of incident dementia among participants with prevalent epilepsy in the Framingham Heart Study (FHS).MethodsWe analyzed prospectively collected data in the Original and Offspring FHS cohorts. To determine the risk of developing epilepsy among participants with dementia and the risk of developing dementia among participants with epilepsy, we used separate, nested, case–control designs and matched each case to 3 age-, sex- and FHS cohort–matched controls. We used Cox proportional hazards regression analysis, adjusting for sex and age. In secondary analysis, we investigated the role of education level and APOE ε4 allele status in modifying the association between epilepsy and dementia.ResultsA total of 4,906 participants had information on epilepsy and dementia and dementia follow-up after age 65. Among 660 participants with dementia and 1,980 dementia-free controls, there were 58 incident epilepsy cases during follow-up. Analysis comparing epilepsy risk among dementia cases vs controls yielded a hazard ratio (HR) of 1.82 (95% confidence interval 1.05–3.16, p = 0.034). Among 43 participants with epilepsy and 129 epilepsy-free controls, there were 51 incident dementia cases. Analysis comparing dementia risk among epilepsy cases vs controls yielded a HR of 1.99 (1.11–3.57, p = 0.021). In this group, among participants with any post–high school education, prevalent epilepsy was associated with a nearly 5-fold risk for developing dementia (HR 4.67 [1.82–12.01], p = 0.001) compared to controls of the same educational attainment.ConclusionsThere is a bi-directional association between epilepsy and dementia. with either condition carrying a nearly 2-fold risk of developing the other when compared to controls.

scholarly journals Impact of dietary fat composition on prediabetes: a 12-year follow-up study

2017 ◽  
Vol 20 (9) ◽  
pp. 1617-1626 ◽  
Author(s):  
Sridevi Krishnan ◽  
Lyn M Steffen ◽  
Chad M Paton ◽  
Jamie A Cooper
Keyword(s):  
Fatty Acid ◽  
Proportional Hazards ◽  
Large Population ◽  
Cox Proportional Hazards ◽  
High Intake ◽  
Atherosclerosis Risk In Communities ◽  
Daily Energy ◽  
Fat Composition ◽  
Aric Study

AbstractObjectiveDietary fatty acid composition likely affects prediabetic conditions such as isolated impaired fasting glucose (IFG) or impaired glucose tolerance (IGT); however, this risk has not been evaluated in a large population nor has it been followed prospectively.DesignDiet, physical activity, anthropometric, socio-economic and blood glucose data from the Atherosclerosis Risk in Communities (ARIC) study were obtained from BioLINCC. Cox proportional hazards regression models were used to evaluate associations of dietary SFA, MUFA, PUFA,n-3 fatty acid (FA) andn-6 FA intakes with incidence of one (isolated IFG) or two (IFG with IGT) prediabetic conditions at the end of 12-year follow-up.SettingStudy volunteers were from counties in North Carolina, Mississippi, Minnesota and Maryland, USA.SubjectsData from 5288 volunteers who participated in the ARIC study were used for all analyses reported herein.ResultsThe study population was 62% male and 84 % white, mean age 53·5 (sd5·7) years and mean BMI 26·2 (sd4·6) kg/m2. A moderately high intake of dietary MUFA (10–15 % of total daily energy) was associated with a 10 % reduced risk of isolated IFG incidence, while a high intake ofn-3 FA (>0·15 % of total daily energy) was associated with a 10 % increase in risk. Curiously, moderately high intake ofn-6 PUFA (4–5 % of total daily energy) was associated with a 12 % reduction in IFG and IGT incidence.ConclusionsMUFA,n-3 andn-6 FA contribute differently to the development of isolated IFGv. IFG with IGT; and their mechanism may be more complex than originally proposed.

Abstract MP34: The Association Between Periodontal Disease And Incident Heart Failure: The Atherosclerosis Risk In Communities Study

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Rebecca L Molinsky ◽  
Faye L Norby ◽  
Bing Yu ◽  
Amil M Shah ◽  
Pamela L Lutsey ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Periodontal Disease ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Atherosclerosis Risk In Communities ◽  
Increased Risk ◽  
Atherosclerosis Risk ◽  
Incident Heart Failure

Introduction: Periodontal disease, resulting from inflammatory host-response to dysbiotic subgingival microbiota, has been associated with incident hypertension, heart attack, stroke and diabetes. Limited data exist investigating the prospective relationship between periodontal disease and incident heart failure (HF) and HF subtypes. We hypothesize that periodontal disease is associated with increased risk for heart failure with preserved ejection fraction (HFpEF) and heart failure with reduced ejection fraction (HFrEF). Methods: We studied 6,707 participants enrolled in the Atherosclerosis Risk in Communities Study who received a full-mouth clinical periodontal examination at visit 4 (1996-1998) and had longitudinal follow-up starting in 2005. Participants were classified as being periodontally healthy, having periodontal disease (based on the Periodontal Profile Classification (PPC)), or being edentulous. Hospitalization records were reviewed, and HF events were adjudicated and classified as HFpEF, HFrEF or HF of unknown ejection fraction (HFunknownEF) from 2005-2018. We used multivariable-adjusted Cox proportional hazards models to assess the association between periodontal disease or edentulism and incident HF. Results: Among participants 58% had periodontitis and 19% were edentulous. During a median follow-up time of 13 years, 1,178 cases of incident HF occurred (350 HFpEF, 319 HFrEF and 509 HFunknownEF). Periodontal disease and being edentulous were both associated with increased risk for both HFpEF and HFrEF (Table). Conclusion: Periodontal disease measured in mid-life was associated with both incident HFpEF and HFrEF. Adverse microbial exposures underlying periodontal disease might represent a modifiable risk factor for inflammation-induced heart failure pathophysiology.

The prognostic significance of lymphovascular tumor invasion in localized high-grade osteosarcoma: Outcomes of a single institution over ten years.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e22013-e22013
Author(s):  
Charles Gusho ◽  
Ira Miller ◽  
Bishir Clayton ◽  
Matthew W. Colman ◽  
Steven Gitelis ◽  
...  
Keyword(s):  
Cumulative Incidence ◽  
Tumor Invasion ◽  
Proportional Hazards ◽  
Prognostic Significance ◽  
Cox Proportional Hazards ◽  
High Grade ◽  
Dismal Prognosis ◽  
Confounding Variables ◽  
High Grade Osteosarcoma

e22013 Background: Lymphovascular tumor invasion (LVI) has shown evidence of an association with worse survival in high-grade osteosarcoma. The purpose of this investigation was to prognosticate LVI as a predictor of survival in these patients. Methods: This study was a retrospective review of high-grade, localized osteosarcoma patients diagnosed over a consecutive ten-year period. Cox proportional hazards regression was used to assess the prognostic significance of LVI on overall survival (OS). Results: A total of 42 cases met inclusion criteria with a median follow-up of 64 months (range, 6-158 months). LVI was present in 21.4% (n = 9) cases. The five and ten-year probabilities of OS in LVI (+) were 40% and 20%, respectively, compared to LVI (-) with five and ten-year estimates of 93% and 81%, respectively (p < 0.001). After controlling for confounding variables, advanced age at diagnosis (HR, 1.134; 95% CI, 1-1.2; p = 0.01) and LVI (HR, 21.768; 95% CI, 3-135; p = 0.001) were found to be significantly negative predictors of OS. Using a competing risk analysis and Gray's test of equality, LVI (+) and LVI (-) were not statistically different with respect to cumulative incidence of recurrence (p = 0.8118), though were highly significant for cumulative incidence of mortality over time (p = 0.0029). Conclusions: The presence of LVI in the setting of high-grade, localized osteosarcoma is associated with greater rates of mortality and tumor recurrence and portends a dismal prognosis.

scholarly journals Role of social benefits for future long-term sickness absence, disability pension and unemployment among individuals on sickness absence due to mental diagnoses: a competing risk approach

2021 ◽  
Author(s):  
Annina Ropponen ◽  
Jurgita Narusyte ◽  
Mo Wang ◽  
Sanna Kärkkäinen ◽  
Lisa Mather ◽  
...  
Keyword(s):  
Sickness Absence ◽  
Cumulative Incidence ◽  
Disability Pension ◽  
Social Insurance ◽  
Proportional Hazards ◽  
Population Based ◽  
Cox Proportional Hazards ◽  
Social Benefits

Abstract Purpose To investigate associations between social benefits and disability pension (DP), long-term sickness absence (LTSA, ≥ 90 days), or unemployment among Swedish twins with sickness absence (SA) due to mental diagnoses. Methods This population-based prospective twin study included register data on first incident SA spell (< 90 days) due to mental diagnoses (ICD 10 codes F00-F99) during the follow-up 2005–2016. SA < 90 days due to other diagnoses than mental diagnoses or any other social insurance benefit was identified for the preceding year of the first incident SA spell due to mental diagnoses (coded yes/no). Comparing those with any previous social benefits vs without, cumulative incidence curve to compare time to an event, and Cox proportional hazards models for cause-specific hazard ratios (HR, 95% confidence intervals, CI) treating first incident DP, LTSA and unemployment as competing risks were modeled. Results During follow-up, 21 DP, 1619 LTSA, and 808 unemployment events took place. Compared to those without, those with at least one benefit had a higher risk for DP (HR 5.03; 95%CI 1.80, 14.01), LTSA (1.67; 1.50, 1.84) and unemployment (1.24; 1.03, 1.50). The cumulative incidence for DP was very low, < 1%, for LTSA 80% with any previous social benefits vs. 60% without, and for unemployment ≤ 5%. Conclusion Social benefits received during the preceding year of SA due to mental diagnoses (< 90 days) predict DP, LTSA, and unemployment. Hence, previous social benefits may provide means for early identification of persons at risk for exit from labor market.

scholarly journals Intrinsic Frequencies of Carotid Pressure Waveforms Predict Heart Failure Events

Hypertension ◽  
2021 ◽  
Author(s):  
Leroy L. Cooper ◽  
Jian Rong ◽  
Niema M. Pahlevan ◽  
Derek G. Rinderknecht ◽  
Emelia J. Benjamin ◽  
...  
Keyword(s):  
Heart Failure ◽  
Proportional Hazards ◽  
Vascular System ◽  
Cox Proportional Hazards ◽  
Frequency Variation ◽  
Cvd Risk ◽  
Generation Cohorts ◽  
Heart Study ◽  
The Difference

Intrinsic frequencies (IFs) derived from arterial waveforms are associated with cardiovascular performance, aging, and prevalent cardiovascular disease (CVD). However, prognostic value of these novel measures is unknown. We hypothesized that IFs are associated with incident CVD risk. Our sample was drawn from the Framingham Heart Study Original, Offspring, and Third Generation Cohorts and included participants free of CVD at baseline (N=4700; mean age 52 years, 55% women). We extracted 2 dominant frequencies directly from a series of carotid pressure waves: the IF of the coupled heart and vascular system during systole (ω 1 ) and the IF of the decoupled vasculature during diastole (ω 2 ). Total frequency variation (Δω) was defined as the difference between ω 1 and ω 2 . We used Cox proportional hazards regression models to relate IFs to incident CVD events during a mean follow-up of 10.6 years. In multivariable models adjusted for CVD risk factors, higher ω 1 (hazard ratio [HR], 1.14 [95% CI], 1.03–1.26]; P =0.01) and Δω (HR, 1.16 [95% CI, 1.03–1.30]; P =0.02) but lower ω 2 (HR, 0.87 [95% CI, 0.77–0.99]; P =0.03) were associated with higher risk for incident composite CVD events. In similarly adjusted models, higher ω 1 (HR, 1.23 [95% CI, 1.07–1.42]; P =0.004) and Δω (HR, 1.26 [95% CI, 1.05–1.50]; P =0.01) but lower ω 2 (HR, 0.81 [95% CI, 0.66–0.99]; P =0.04) were associated with higher risk for incident heart failure. IFs were not significantly associated with incident myocardial infarction or stroke. Novel IFs may represent valuable markers of heart failure risk in the community.

scholarly journals Association of Serious Fall Injuries among United States End Stage Kidney Disease Patients with Access to Kidney Transplantation

2018 ◽  
Vol 13 (4) ◽  
pp. 628-637 ◽  
Author(s):  
Laura C. Plantinga ◽  
Raymond J. Lynch ◽  
Rachel E. Patzer ◽  
Stephen O. Pastan ◽  
C. Barrett Bowling
Keyword(s):  
United States ◽  
Confidence Interval ◽  
Kidney Transplant ◽  
Cumulative Incidence ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Hazard Ratio ◽  
Fall Injuries ◽  
Fall Injury

Background and objectivesSerious fall injuries in the setting of ESKD may be associated with poor access to kidney transplant. We explored the burden of serious fall injuries among patients on dialysis and patients on the deceased donor waitlist and the associations of these fall injuries with waitlisting and transplantation.Design, setting, participants, & measurementsOur analytic cohorts for the outcomes of (1) waitlisting and (2) transplantation included United States adults ages 18–80 years old who (1) initiated dialysis (n=183,047) and (2) were waitlisted for the first time (n=37,752) in 2010–2013. Serious fall injuries were determined by diagnostic codes for falls plus injury (fracture, joint dislocation, or head trauma) in inpatient and emergency department claims; the first serious fall injury after cohort entry was included as a time-varying exposure. Follow-up ended at the specified outcome, death, or the last date of follow-up (September 30, 2014). We used multivariable Cox proportional hazards models to determine the independent associations between serious fall injury and waitlisting or transplantation.ResultsOverall, 2-year cumulative incidence of serious fall injury was 6% among patients on incident dialysis; with adjustment, patients who had serious fall injuries were 61% less likely to be waitlisted than patients who did not (hazard ratio, 0.39; 95% confidence interval, 0.35 to 0.44). Among incident waitlisted patients (4% 2-year cumulative incidence), those with serious fall injuries were 29% less likely than their counterparts to be subsequently transplanted (hazard ratio, 0.71; 95% confidence interval, 0.63 to 0.80).ConclusionsSerious fall injuries among United States patients on dialysis are associated with substantially lower likelihood of waitlisting for and receipt of a kidney transplant.PodcastThis article contains a podcast at https://www.asn-online.org/media/podcast/CJASN/2018_03_06_CJASNPodcast_18_4_P.mp3

Abstract 15973: The Association Between Blood Pressure Control and Outcomes Among Black Participants in the Jackson Heart Study

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Tiffany C Randolph ◽  
Melissa A Greiner ◽  
Chidiebube Egwim ◽  
Adrian F Hernandez ◽  
Kevin L Thomas ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cumulative Incidence ◽  
Proportional Hazards ◽  
Age Groups ◽  
Black Population ◽  
Cox Proportional Hazards ◽  
Jackson Heart Study ◽  
Risk Of Mortality ◽  
Heart Study ◽  
Increased Risk

Introduction: The 2014 hypertension (HTN) guidelines liberalized blood pressure (BP) goals for people ≥60 years. Hypothesis: Increased systolic and diastolic blood pressure (SBP/DBP) will be associated with a higher risk of mortality and heart failure hospitalization (HFH) across all age groups. Methods: We used age-adjusted Kaplan-Meier estimates to calculate the cumulative incidence of mortality and HFH across SBP/DBP categories (Figure) among 5280 participants of the Jackson Heart Study (JHS), an exclusively black population. We used Cox proportional hazards models to investigate associations between baseline visit SBP/DBP and both mortality and HFH. Linearity of associations and differential effects by age were assessed. Results: Median age was 56 years (IQR: 46-65); 63% were female; median SBP was 125 mmHg (IQR: 114-137); and median DBP was 79 mmHg (IQR: 72-86). There were 520 deaths over 9 years and 340 HFHs over 7 years. The age-adjusted cumulative incidence of both mortality and HFH increased with SBP, while rates of both outcomes were similar by DBP (Figure). After multivariable adjustment, every 10 mmHg increase in SBP was associated with increased mortality (HR 1.12 95% CI [1.06, 1.17]; p<.001) and HFH (HR 1.07 95% CI [1.00, 1.14]; p=0.05). The mortality risk per 10mmHg increase in SBP was greater in participants <60 years (HR 1.26 95% CI [1.13, 1.42]; p<.001) than ≥ 60 years (HR 1.09 95% CI [1.03, 1.15]; p=.004). DBP was inversely associated with risk of mortality (HR 0.85 95% CI [0.77, 0.94]; p= .002) and not associated with HFH (p=.20). Conclusions: In this JHS cohort, SBP was associated with both mortality and HFH, while DBP was inversely associated with mortality. Adults across all age groups were at increased risk of mortality as SBP increased. In the context of new HTN guidelines, these findings have important implications and should be considered when determining BP treatment goals in Black patients.

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