scholarly journals Age-specific associations between systolic blood pressure and cardiovascular mortality

Heart ◽  
2019 ◽  
Vol 105 (14) ◽  
pp. 1070-1077 ◽  
Author(s):  
Mi-Hyang Jung ◽  
Sang-Wook Yi ◽  
Sang Joon An ◽  
Jee-Jeon Yi
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Age Groups ◽  
The Elderly ◽  
Stroke Mortality ◽  
Linear Association ◽  
Sample Data ◽  
Korean National Health Insurance ◽  
Cvd Mortality

ObjectiveWe aimed to identify the following in all age groups among individuals without known hypertension and CVD: (1) Whether a systolic blood pressure (SBP) of 130–139 mm Hg elevates cardiovascular disease (CVD) mortality. (2) Whether SBP shows a linear association with cause-specific CVD mortality.MethodsWe used the Korean National Health Insurance sample data (n=429 220). Participants were categorised into three groups by age (40–59 years, 60–69 years and 70–80 years).ResultsDuring 10.4 years of follow-up, 4319 cardiovascular deaths occurred. A positive and graded association was generally observed between SBP and overall and cause-specific CVD mortality regardless of age, except for ischaemic heart disease (IHD) mortality in those aged 70–80 years. Among those aged 70–80 years, the HRs (95% CIs) for overall CVD mortality were 1.08 (0.92–1.28), 1.14 (0.97–1.34) and 1.34 (1.14–1.58) for SBP values of 120–129 mm Hg, 130–139 mm Hg and 140–149 mm Hg, respectively, compared with SBP <120 mm Hg. For total stroke mortality, the corresponding HRs were 1.29 (1.02–1.64), 1.37 (1.09–1.72) and 1.52 (1.20–1.93), while for IHD mortality, the corresponding HRs were 0.90 (0.64–1.26), 0.86 (0.62–1.19) and 1.29 (0.93–1.78), respectively. Non-linear associations were significant for IHD.ConclusionsIn the elderly Korean population, SBPs of 130–139 mm Hg elevated total stroke mortality, but not IHD mortality, compared with normal blood pressure, and a linear association was not observed for IHD mortality in the range <140 mm Hg.

P5728Association of systolic blood pressure and cardiovascular outcomes at different age groups in the healthy general population: a nationwide prospective cohort study

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M H Jung ◽  
S H Ihm ◽  
S J An ◽  
S W Yi
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Age Groups ◽  
The Elderly ◽  
Cardiovascular Outcomes ◽  
Stroke Mortality ◽  
Linear Association ◽  
Hazard Ratios ◽  
Individualized Approach ◽  
Cvd Mortality

Abstract Background Uncertainties remain regarding the effect of blood pressure on various cardiovascular outcomes in different age groups. Purpose We aimed to identify 1) whether a systolic blood pressure (SBP) of 130–139 mm Hg elevates cardiovascular disease (CVD) mortality and 2) whether SBP shows a linear association with cause-specific CVD mortality in all age groups among individuals without known hypertension and CVD. Methods We used the Korean National Health Insurance sample data (n=429,220). Participants were categorized into three groups by age (40–59, 60–69, and 70–80 years). Results A positive and graded association was generally observed between SBP and overall and cause-specific CVD mortality regardless of age, except for ischemic heart disease (IHD) mortality in those aged 70–80 years. Among those aged 70–80, the hazard ratios (HRs) (95% CIs) for overall CVD mortality were 1.08 (0.92–1.28), 1.14 (0.97–1.34), and 1.34 (1.14–1.58) for SBP values of 120–129, 130–139, and 140–149 mm Hg, respectively, compared to SBP <120 mm Hg. For total stroke mortality, the corresponding HRs were 1.29 (1.02–1.64), 1.37 (1.09–1.72), and 1.52 (1.20–1.93), while for IHD mortality, the corresponding HRs were 0.90 (0.64–1.26), 0.86 (0.62–1.19), and 1.29 (0.93–1.78). Nonlinear associations were significant for IHD (Fig 1). Figure 1 Conclusion In the elderly Korean population, SBPs of 130–139 mm Hg elevated total stroke mortality, but not IHD mortality, compared to normal BP, and a linear association was not observed for IHD mortality in the range <140 mm Hg. Regarding an appropriate diagnostic cutoff for hypertension, an individualized approach considering each person's organ susceptibility is needed for the elderly population. Acknowledgement/Funding None

Defining Hypotension in Moderate to Severely Injured Trauma Patients: Raising the Bar for the Elderly

2010 ◽  
Vol 76 (10) ◽  
pp. 1035-1038 ◽  
Author(s):  
Meghan Edwards ◽  
Eric Ley ◽  
James Mirocha ◽  
Anoushiravan Amini Hadjibashi ◽  
Daniel R. Margulies ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Los Angeles ◽  
Systolic Blood Pressure ◽  
Hemorrhagic Shock ◽  
Head Injuries ◽  
Age Groups ◽  
The Elderly ◽  
Trauma Patients ◽  
Severely Injured ◽  
Definition Of

Hypotension, defined as systolic blood pressure less than 90 mm Hg, is recognized as a sign of hemorrhagic shock and is a validated prognostic indicator. The definition of hypotension, particularly in the elderly population, deserves attention. We hypothesized that the systolic blood pressure associated with increased mortality resulting from hemorrhagic shock increases with increasing age. The Los Angeles County Trauma Database was queried for all moderate to severely injured patients without major head injuries admitted between 1998 and 2005. Several fit statistic analyses were performed for each systolic blood pressure from 50 to 180 mm Hg to identify the model that most accurately defined hypotension for three age groups. The optimal definition of hypotension for each group was determined from the best fit model. A total of 24,438 patients were analyzed. The optimal definition of hypotension was systolic blood pressure of 100 mm Hg for patients 20 to 49 years, 120 mm Hg for patients 50 to 69 years, and 140 mm Hg for patients 70 years and older. The optimal systolic blood pressure for improved mortality in hemorrhagic shock increases significantly with increasing age. Elderly trauma patients without major head injuries should be considered hypotensive for systolic blood pressure less than 140 mm Hg.

scholarly journals Age-period-cohort analysis of stroke mortality attributable to high systolic blood pressure in China and Japan

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jinhong Cao ◽  
Ehab S. Eshak ◽  
Keyang Liu ◽  
Ahmed Arafa ◽  
Haytham A. Sheerah ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Cohort Analysis ◽  
Temporal Trends ◽  
Age Groups ◽  
Stroke Mortality ◽  
High Systolic Blood Pressure ◽  
Men And Women ◽  
China And Japan ◽  
Disease Study

AbstractStroke is a principal cause of mortality in China and Japan. High systolic blood pressure (SBP) was considered a chief risk factor for stroke mortality. Herein, we evaluated temporal trends of high SBP-attributable stroke mortality in China and Japan between 1990 and 2017. Data on stroke mortality were retrieved from the Global Burden of Disease Study 2017 (GBD 2017). Using the age-period-cohort method, we computed overall net drifts, local drifts, longitudinal age curves, and cohort/period rate ratios (RRs) for high SBP-attributable stroke mortality. The age-standardized mortality rates (ASMRs) displayed decreasing trends for high SBP-attributable stroke mortality. The annual net drift values were − 1.4% and − 3.5% in Chinese men and women versus − 3.1% and − 4.9% in Japanese men and women. The local drift values in both countries were < 0 among all age groups but were lower in women than in men. The longitudinal age curves showed a greater high SBP-attributable stroke mortality in men than in women across all age groups. Similar decreasing patterns were shown in the period and cohort RRs in both sexes with women having a quicker decline than men. In China and Japan, the ASMRs, as well as the period and cohort RRs of high SBP-attributable stroke mortality, decreased between 1990 and 2017 in both sexes and across all age groups. Yet, the prevalence of high SBP remained worrisome in both countries. Thus, SBP control should be encouraged to prevent stroke mortality.

scholarly journals Systolic Blood Pressure and Cognition in the Elderly: The Northern Manhattan Study

2021 ◽  
pp. 1-11
Author(s):  
Xiaoyan Sun ◽  
Chuanhui Dong ◽  
Bonnie Levin ◽  
Michelle Caunca ◽  
Adina Zeki Al Hazzouri ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Executive Function ◽  
Systolic Blood Pressure ◽  
Processing Speed ◽  
Ethnically Diverse ◽  
The Elderly ◽  
Vascular Risk ◽  
Cross Sectional

Background: Increasing evidence suggests that hypertension is a risk factor for cognitive impairment and dementia. The relationship between blood pressure and cognition in a racially and ethnically diverse population remains unclear. Objective: To study association of blood pressure with cognition cross-sectionally and longitudinally in the elderly. Methods: Participants are stroke-free individuals from the racially and ethnically diverse Northern Manhattan Study (NOMAS) (n = 1215). General linear models are constructed to examine blood pressure in relation to cognition cross-sectionally and longitudinally at a five-year follow-up. Results: We found a cross-sectional association of systolic blood pressure (SBP) with word fluency/semantic memory, executive function, and processing speed/visual motor integration (VMI) function. This association was independent of demographics, vascular risk factors, white matter hyperintensity volume (WMHV), and carotid intima-media thickness (cIMT). The cross-sectional association of SBP with processing speed/VMI and executive function was attenuated after adjusting anti-hypertension medications in the models. Baseline SBP was associated with the change of processing speed/VMI function after adjusting vascular risk factors, WMHV, and cIMT at a 5-year follow-up. This longitudinal association was not found after adjusting anti-hypertension medications in the models. Further analyses revealed that individuals with category SBP from <  120 mmHg to≥140 mmHg had a linear decline in processing speed/VMI function at a 5-year follow-up. Conclusion: We show that SBP is negatively associated with cognition cross-sectionally and longitudinally in the elderly. Anti-hypertension treatment eliminates the negative association of SBP with processing speed/VMI function longitudinally. Our findings support the treatment of stage 1 systolic hypertension in the elderly.

School children systolic and diastolic blood pressure values: YUSAD study

Open Medicine ◽  
2011 ◽  
Vol 6 (5) ◽  
pp. 634-639
Author(s):  
Zeljka Milincic ◽  
Dejan Nikolic ◽  
Slavko Simeunovic ◽  
Ivana Novakovic ◽  
Ivana Petronic ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Pressure Fluctuations ◽  
Age Groups ◽  
Old Patients ◽  
Hypertensive Group ◽  
Group 3 ◽  
Group 2

AbstractThe aim of the study was to analyze changes of systolic and diastolic blood pressure values over five and ten years separately boys and girls and to estimate correlation between them. Three age groups from 8 centers in Serbia were evaluated: Group 1: 10 year old patients, Group 2: 15 year old and Group 3: 20 year old. Group with normal blood pressure values, prehypertensive and hypertensive group were analyzed. Regarding the period of follow-up we analyzed: 10/15 years period-children between 10 and 15 years, 15/20 years period-children between 15 and 20 years, and 10/20 years period-children between 10 and 20 years. Significant increase of diastolic blood pressure was noticed for both genders in 10/15 years period of prehypertensive population, while in hypertensive children, boys showed decline in frequency for systolic and diastolic blood pressure and girls only for diastolic. In 15/20 years period there was significant decrease of prehypertensive and significant increase of hypertensive diastolic blood pressure frequency. In 10/20 years period significant reduction in frequency of prehypertensive systolic blood pressure was noticed, while only hypertensive group of boys showed significant reduction regarding systolic blood pressure frequency. Prehypertensive diastolic and hypertensive systolic blood pressure fluctuations are more related to age.

Strategy for the Prevention of Cardiovascular Diseases in East Asian Countries Based on the Experience of Japan

2011 ◽  
Vol 3 (1) ◽  
pp. 10
Author(s):  
Hirotsugu Ueshima ◽  
Keyword(s):  
Blood Pressure ◽  
Risk Factor ◽  
Mortality Rate ◽  
Salt Intake ◽  
East Asian ◽  
Age Groups ◽  
Blood Pressure Level ◽  
The Elderly ◽  
Stroke Mortality ◽  
Asian Countries

Cardiovascular disease is a major cause of morbidity and mortality in East Asian countries as well as in western countries. However, it is a characteristic specific to East Asia that stroke is more prevalent than coronary heart disease (CHD). In 1965, Japan had the highest stroke mortality rate in the world, but the rate has since declined substantially: the age-adjusted stroke mortality rate fell by around 80% from 1965 to 1990. Risk factors for stroke in Asian countries include hypertension, smoking and diabetes. Hypercholesterolaemia is not a strong risk factor for stroke or even for ischemic stroke, but it is a risk factor for CHD in Asian countries as well as in western counties. Therefore, the control of blood pressure and diabetes and cessation of smoking are crucial for preventing stroke and disability in the elderly. During the last four decades in Japan, the blood pressure level has fallen among both sexes and in all age groups: the systolic blood pressure (SBP) of men 60–69 years of age fell by 16mmHg from 1965 to 1990. This is estimated to have reduced stroke mortality by around 50% because, based on Japanese cohort studies, an SBP reduction of 1mmHg may lead to a 3% reduction in the incidence of stroke. Similarly, a 1% reduction in the incidence of smoking may lead to a 1.3% reduction in the incidence of stroke, so the 20% reduction of the smoking rate during this period is estimated to have led to a 26% reduction in the incidence of stroke. In addition, the significant reduction in salt consumption over this time period, by at least 10–15g per day, has substantially reduced blood pressure among the Japanese population. Lowering blood pressure by reducing salt intake, promoting smoking cessation and preventing diabetes are therefore key strategies for preventing stroke and disability in the elderly.

scholarly journals Association between systolic blood pressure trajectories and hypertension risk at late adolescence: results from 10-year longitudinal follow-up in Chinese boys

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e042594
Author(s):  
Xijie Wang ◽  
Bin Dong ◽  
Sizhe Huang ◽  
Zhaogeng Yang ◽  
Jun Ma ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Late Adolescence ◽  
Population Based ◽  
Incidence Rates ◽  
Hypertension Risk ◽  
Logit Regression ◽  
Binomial Regression ◽  
Physical Examinations

ObjectiveTo identify various systolic blood pressure (SBP) trajectories in Chinese boys between 7 and 18 years of age, and to explore their high blood pressure (HBP) risk in their late adolescence years.Design and settingsA population-based cohort study in Guangdong, China.Participants4541 normal tensive boys who started primary school in 2005 in Zhongshan, Guangdong were included.OutcomesBlood pressure and relevant measurements were obtained by annual physical examinations between 2005 and 2016. HBP was defined by SBP or diastolic blood pressure ≥95th percentile for children under 13, and BP ≥130/80 mm Hg for children ≥13 years old. Logit regression for panel data and log-binomial regression model was used to estimate the risk of HBP among SBP trajectory groups.ResultsFour distinct SBP trajectory groups via group-based trajectory modelling: low stable (13.0%), low rising (42.4%), rising (37.4%) and high rising (7.3%). The overall incidence rates of HBP during the follow-up ranged from 40.24 (95% CI 36.68 to 44.19)/1000 person-years in the low stable group to 97.08 (95% CI 94.93 to 99.27)/1000 person-years in the high rising group. Compared with children with low stable SBP, those of other SBP trajectories suffered 3.05 (95% CI 2.64 to 3.46) to 4.64 (95% CI 4.18 to 5.09) times of higher risk of HBP in their late adolescence, regardless of their age, body mass index and BP level at baseline.ConclusionsSubgroups of SBP trajectories existed in Chinese boys, and are related to hypertension risk at late adolescence. Regular physical examinations could help identify those with higher risks at the beginning of pubertal growth.

scholarly journals Hypertensive response in exercise - a tool to predict stroke risk?

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
TE Graca Rodrigues ◽  
N Cunha ◽  
P Silverio-Antonio ◽  
P Couto Pereira ◽  
B Valente Silva ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Exercise Test ◽  
Cardiovascular Events ◽  
Protective Factor ◽  
Independent Predictor ◽  
Stress Test ◽  
Coronary Syndrome

Abstract Funding Acknowledgements Type of funding sources: None. Introduction There is some evidence suggesting that exaggerated hypertensive response to exercise (HRE) may be associated with higher risk of future cardiovascular events, however the relationship between systolic blood pressure (SPB) during exercise test and stroke is not fully understood. Purpose To evaluate the ability to predict the risk of stroke in patients with HRE in exercise test. Methods Single-center retrospective study of consecutive patients submitted to exercise test from 2012 to 2015 with HRE to stress test. HRE was defined as a peak systolic blood pressure (PSBP) &gt; 210 mmHg in men and &gt; 190 mmHg in women, or a rise of the SBP of 60 mmHg in men or 50 mmHg in women or as a diastolic blood pressure &gt; 90 mmHg or a rise of 10 mmHg. Patient’s demographics, baseline clinical characteristics, vital signs during the stress test and the occurrence of stroke during follow-up were analysed Results We included 458 patients with HRE (76% men, 57.5 ± 10.83 years). The most frequent comorbidities were hypertension (83%), dyslipidaemia (61%), previously known coronary disease (32%), diabetes (28%) and smoking (38%). Atrial fibrillation was present in 5.9% of patients. During a mean follow-up of 60 ± 2 months, the incidence of stroke was 2.1% (n = 8), all with ischemic origin. Considering the parameters analysed on exercise test, only PSBP demonstrated to be an independent predictor of stroke (HR 1.042, CI95% 1.002-1.084, p = 0.039,) with moderate ability to predict stroke (AUC 0.735, p = 0.0016) with a most discriminatory value of 203 mmHg (sensibility 56%, specify 67%). Regarding baseline characteristics, after age, sex and comorbidities adjustment, previously controlled hypertension was found to be an independent protective factor of stroke (OR 4.247, CI 95% 0.05-0.9, p = 0.036) and atrial fibrillation was an independent predictor of stroke occurrence (HR 8.1, CI95% 1.4-46.9, p = 0.018). Atrial fibrillation was also associated with hospitalization of cardiovascular cause and major cardiovascular events occurrence (mortality, coronary syndrome and stroke). Baseline SBP was associated with atrial fibrillation development (p = 0.008). Conclusion According to our results, PSBP during exercise test is an independent predictor of stroke occurrence and should be considered as a potencial additional tool to predict stroke occurrence, particularly in high risk patients. The identification of diagnosed hypertension as a protective factor of stroke may be explained by the cardioprotective effect of antihypertensive drugs.

scholarly journals Incidence and predictors of hospitalization in patients with atrial fibrillation: results from the Chinese atrial fibrillation registry study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhaojie Dong ◽  
Xin Du ◽  
Shangxin Lu ◽  
Chao Jiang ◽  
Shijun Xia ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cardiovascular Diseases ◽  
Risk Model ◽  
Age Groups ◽  
Gastrointestinal Disorder ◽  
The Elderly ◽  
Chronic Obstructive ◽  
Unique Identifier ◽  
Clinical Registry

Abstract Background Patients with atrial fibrillation (AF) underwent a high risk of hospitalization, which has not been paid much attention to in practice. Therefore, we aimed to assess the incidence, causes and predictors of hospitalization in AF patients. Methods From August 2011 to December 2017, a total number of 20,172 AF patients from the Chinese Atrial Fibrillation Registry (China-AF) Study were prospectively selected for this study. We described the incidence, causes of hospitalization by age groups and sex. The Fine-Gray competing risk model was employed to identify predictors of first all-cause and first cause-specific hospitalization. Results After a mean follow-up of 37.3 ± 20.4 months, 7,512 (37.2%) AF patients experienced one or more hospitalizations. The overall incidence of all-cause hospitalization was 24.0 per 100 patient-years. Patients aged < 65 years were predominantly hospitalized for AF (42.1% of the total hospitalizations); while patients aged 65–74 and ≥ 75 years were mainly hospitalized for non-cardiovascular diseases (43.6% and 49.3%, respectively). We found patients complicated with heart failure (HF)[hazard ratio (HR) 1.10, 95% confidence interval (CI) 1.02–1.18], established coronary artery disease (CAD) (HR 1.24, 95%CI 1.17–1.33), ischemic stroke/transient ischemic attack (TIA) (HR 1.22, 95%CI 1.15–1.30), diabetes (HR 1.14, 95%CI 1.08–1.20), chronic obstructive pulmonary disease (COPD) (HR 1.28, 95%CI 1.02–1.62), gastrointestinal disorder (HR 1.37, 95%CI 1.21–1.55), and renal dysfunction (HR 1.24, 95%CI 1.09–1.42) had higher risks of hospitalization. Conclusions More than one-third of AF patients included in this study were hospitalized at least once during over 3-year follow-up. The main cause for hospitalization among the elderly patients (≥ 65 years) is non-cardiovascular diseases rather than AF. Multidisciplinary management of comorbidities should be advocated to reduce hospitalization in AF patients older than 65 years old. Clinical Registryhttp://www.chictr.org.cn/showproj.aspx?proj=5831. Unique identifier: ChiCTR-OCH-13003729. The registration date is October 22, 2013.

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