scholarly journals Racial/ethnic heterogeneity in associations of blood pressure and incident cardiovascular disease by functional status in a prospective cohort: the Multi-Ethnic Study of Atherosclerosis

BMJ Open ◽  
2018 ◽  
Vol 8 (2) ◽  
pp. e017746 ◽  
Author(s):  
Paulina Kaiser ◽  
Carmen A. Peralta ◽  
Richard Kronmal ◽  
Michael G. Shlipak ◽  
Bruce M Psaty ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Older Adults ◽  
Systolic Blood Pressure ◽  
Functional Status ◽  
High Blood Pressure ◽  
Effect Modification ◽  
Physical Limitations ◽  
Racial Ethnic ◽  
Incident Cardiovascular Disease

ObjectivesResearch has demonstrated that the association between high blood pressure and outcomes is attenuated among older adults with functional limitations, compared with healthier elders. However, it is not known whether these patterns vary by racial/ethnic group. We evaluated race/ethnicity-specific patterns of effect modification in the association between blood pressure and incident cardiovascular disease (CVD) by functional status.SettingWe used data from the Multi-Ethnic Study of Atherosclerosis (2002–2004, with an average of 8.8 years of follow-up for incident CVD). We assessed effect modification of systolic blood pressure and cardiovascular outcomes by self-reported physical limitations and by age.ParticipantsThe study included 6117 participants (aged 46 to 87; 40% white, 27% black, 22% Hispanic and 12% Chinese) who did not have CVD at the second study examination (when self-reported physical limitations were assessed).Outcome measuresIncident CVD was defined as an incident myocardial infarction, coronary revascularisation, resuscitated cardiac arrest, angina, stroke (fatal or non-fatal) or death from CVD.ResultsWe observed weaker associations between systolic blood pressure (SBP) and CVD among white adults with physical limitations (incident rate ratio (IRR) per 10 mm Hg higher SBP: 1.09 (95% CI 0.99 to 1.20)) than those without physical limitations (IRR 1.29 (1.19, 1.40); P value for interaction <0.01). We found a similar pattern among black adults. Poor precision among the estimates for Hispanic or Chinese participants limited the findings in these groups. The attenuated associations were consistent across both multiplicative and additive scales, though physical limitations showed clearer patterns than age on an additive scale.ConclusionAttenuated associations between high blood pressure and incident CVD were observed for blacks and whites with poor function, though small sample sizes remain a limitation for identifying differences among Hispanic or Chinese participants. Identifying the characteristics that distinguish those in whom higher SBP is associated with less risk of morbidity or mortality may inform our understanding of the consequences of hypertension among older adults.

scholarly journals High Blood Pressure and All-Cause and Cardiovascular Disease Mortalities in Community-Dwelling Older Adults

Medicine ◽  
2015 ◽  
Vol 94 (47) ◽  
pp. e2160 ◽  
Author(s):  
Chen-Yi Wu ◽  
Hsiao-Yun Hu ◽  
Yiing-Jenq Chou ◽  
Nicole Huang ◽  
Yi-Chang Chou ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Older Adults ◽  
High Blood Pressure ◽  
Community Dwelling ◽  
Community Dwelling Older Adults

scholarly journals APOL1 Renal-Risk Variants Do Not Associate With Incident Cardiovascular Disease or Mortality in the Systolic Blood Pressure Intervention Trial

2017 ◽  
Vol 2 (4) ◽  
pp. 713-720 ◽  
Author(s):  
Barry I. Freedman ◽  
Michael V. Rocco ◽  
Jeffrey T. Bates ◽  
Michel Chonchol ◽  
Amret T. Hawfield ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Systolic Blood Pressure ◽  
Intervention Trial ◽  
Risk Variants ◽  
Incident Cardiovascular Disease

scholarly journals Effects of Cranberry Juice Supplementation on Cardiovascular Disease Risk Factors in Adults with Elevated Blood Pressure: A Randomized Controlled Trial

Nutrients ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 2618
Author(s):  
Chesney K. Richter ◽  
Ann C. Skulas-Ray ◽  
Trent L. Gaugler ◽  
Stacey Meily ◽  
Kristina S. Petersen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Systolic Blood Pressure ◽  
Vascular Function ◽  
Elevated Blood Pressure ◽  
Elevated Blood ◽  
Lipoprotein Profile ◽  
Cranberry Juice ◽  
Central Systolic Blood Pressure

Emerging cardiovascular disease (CVD) risk factors, including central vascular function and HDL efflux, may be modifiable with food-based interventions such as cranberry juice. A randomized, placebo-controlled, crossover trial was conducted in middle-aged adults with overweight/obesity (n = 40; mean BMI: 28.7 ± 0.8 kg/m2; mean age: 47 ± 2 years) and elevated brachial blood pressure (mean systolic/diastolic BP: 124 ± 2/81 ± 1 mm Hg). Study participants consumed 500 mL/d of cranberry juice (~16 fl oz; 27% cranberry juice) or a matched placebo juice in a randomized order (8-week supplementation periods; 8-week compliance break), with blood samples and vascular measurements obtained at study entry and following each supplementation period. There was no significant treatment effect of cranberry juice supplementation on the primary endpoint of central systolic blood pressure or central or brachial diastolic pressure. Cranberry juice significantly reduced 24-h diastolic ambulatory BP by ~2 mm Hg compared to the placebo (p = 0.05) during daytime hours. Cranberry juice supplementation did not alter LDL-C but significantly changed the composition of the lipoprotein profile compared to the placebo, increasing the concentration of large LDL-C particles (+29.5 vs. −6.7 nmol/L; p = 0.02) and LDL size (+0.073 vs. −0.068 nm; p = 0.001). There was no effect of treatment on ex vivo HDL efflux in the total population, but exploratory subgroup analyses identified an interaction between BMI and global HDL efflux (p = 0.02), with greater effect of cranberry juice in participants who were overweight. Exploratory analyses indicate that baseline C-reactive protein (CRP) values may moderate treatment effects. In this population of adults with elevated blood pressure, cranberry juice supplementation had no significant effect on central systolic blood pressure but did have modest effects on 24-hr diastolic ambulatory BP and the lipoprotein profile. Future studies are needed to verify these findings and the results of our exploratory analyses related to baseline health moderators.

Blood Pressure and Intraventricular Hemorrhage in Premature Infants

PEDIATRICS ◽  
1990 ◽  
Vol 86 (6) ◽  
pp. 1006-1006
Author(s):  
V. F. PUCCIO ◽  
M. SOLIANI
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Critically Ill ◽  
High Blood Pressure ◽  
Intracranial Hemorrhage ◽  
Premature Infants ◽  
Intraventricular Hemorrhage ◽  
Mean Blood Pressure ◽  
Central Topic ◽  
Safe Blood

To the Editor.— We have read with great interest the recently published article by Perry et al.1 The need to define "safe" blood pressure levels in the critically ill premature infants is a central topic in the prevention of intracranial hemorrhage. However, in Perry's paper maximum systolic blood pressure and maximum mean blood pressure values are much higher than those reported by previously published articles.2-4 High blood pressure values were reported by Lou and Friis-Hansen5 in nine newborns.

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