Blood pressure variability and the risk of fracture: a nationwide cohort study

2021 ◽  
Author(s):  
Jung Eun Yoo ◽  
Ji Won Yoon ◽  
Hyo Eun Park ◽  
Kyungdo Han ◽  
Dong Wook Shin
Keyword(s):  
Blood Pressure ◽  
Cohort Study ◽  
Hip Fractures ◽  
Blood Pressure Variability ◽  
Positive Association ◽  
Population Based ◽  
Outcome Data ◽  
National Health Insurance System ◽  
Risk Of Fracture ◽  
Quartile Group

Abstract Context Although blood pressure variability (BPV) is associated with various health outcomes, only one study suggested that BPV is correlated with hip fractures. As cardiovascular disease and fractures share similar pathophysiology, there might be a link between BPV and fractures. Objective To investigate the association between BPV and the incident fractures. Design Retrospective cohort study. Setting Population-based, using the Korean National Health Insurance System database. Patients or Other Participants A total of 3,256,070 participants aged 50 and above who participated in ≥3 health examinations within the previous five years, including the index year (2009-2010), were included. Outcome data was obtained through the end of 2016. Exposure BPV was calculated using variability independent of the mean. High variability was defined as the highest quartile of variability. Main Outcome Measures Newly diagnosed fractures. Results During the median follow-up of 7.0 years, there were 337,045 cases of any fracture (10.4%). After adjusting for age, sex, income, lifestyle factors, and comorbidities, a higher risk of fracture was observed with higher quartiles of BPV than the lowest quartile group: the adjusted hazard ratios (95% confidence intervals) for incident any fracture were 1.07 (1.06–1.08) in the higher quartile of systolic BPV, 1.06 (1.05–1.07) in that of diastolic BPV, and 1.07 (1.06–1.08) in that of both systolic and diastolic BPV. Consistent results were noted for vertebral fractures and hip fractures, as well as in various subgroup analyses. Conclusions A positive association was noted between higher BPV and fracture incidence. BPV is an independent predictor for developing fracture.

scholarly journals Relationship between blood pressure levels and ischemic stroke, myocardial infarction, and mortality in very elderly patients taking antihypertensives: a nationwide population-based cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Myung-Sun Song ◽  
Yeon joo Choi ◽  
Hyunjin Kim ◽  
Myung Ji Nam ◽  
Chung-woo Lee ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Blood Pressure ◽  
Cohort Study ◽  
Ischemic Stroke ◽  
Large Population ◽  
Antihypertensive Agents ◽  
Population Based ◽  
Very Elderly ◽  
National Health Insurance System ◽  
All Cause Mortality

Abstract Background In the very elderly, “the lower the better” hypothesis has constantly been contradicted by randomized control trials and various cohort studies, but inconsistency in results led to unclear blood pressure treatment targets. This study aimed to assess the relationship between baseline blood pressure (BP) and ischemic stroke, myocardial infarction, and all-cause mortality in very elderly people treated for hypertension. Methods This large population-based retrospective cohort study was based on the national claims database of the Korean National Health Insurance System, which covers the entire Korean population. 374,250 participants aged ≥ 75 years taking antihypertensive agents were recruited, excluding patients with a history of previous ischemic stroke or myocardial infarction. Results Systolic BP (SBP) followed a J curve for ischemic stroke and a U curve for all-cause mortality, with nadir ranges of 120 to 129 mmHg and 140 to 149 mmHg, respectively. While increasing diastolic BP (DBP) generally resulted in higher HRs for ischemic stroke, HRs for myocardial infarction and all-cause mortality significantly increased only when DBP was ≥ 80 mmHg and ≥ 90 mmHg, respectively. The SBP/DBP combination analysis showed that even with SBP < 130 mmHg, higher DBP ≥ 90 mmHg had higher HRs for all three outcomes compared to the reference group (130 to 149 / < 80 mmHg). Conclusions There were no further benefits or even harm below certain BP levels for ischemic stroke, myocardial infarction, and all-cause mortality in very elderly hypertensive patients.

Higher risk for meningioma in women with uterine myoma: a nationwide population-based retrospective cohort study

2014 ◽  
Vol 120 (3) ◽  
pp. 655-661 ◽  
Author(s):  
Yu-Shu Yen ◽  
Li-Min Sun ◽  
Cheng-Li Lin ◽  
Shih-Ni Chang ◽  
Fung-Chang Sung ◽  
...  
Keyword(s):  
Cohort Study ◽  
Age Groups ◽  
Positive Association ◽  
Population Based ◽  
Uterine Myoma ◽  
National Health Insurance System ◽  
Population Based Study ◽  
Taiwanese Women ◽  
Significant Difference ◽  
Age Range

Object Evidence suggests that hormones play a role in modifying both uterine myoma (UM) and meningioma. A number of studies have observed the positive association between these diseases. The aim of the current population-based study was to determine if women with UM are at a higher risk for meningioma. Methods The authors used data from the National Health Insurance system of Taiwan for the study. The UM cohort contained 281,244 women. Each woman was randomly frequency-matched with 4 women without UM, based on age, index year of diagnosis, occupation, urbanization (urbanization level was categorized by the population density of the residential area into 4 levels, with Level 1 as the most urbanized and Level 4 as the least urbanized), and comorbidity, to form the control cohort. Cox's proportional hazard regression analysis was conducted to estimate the influence of UM on the meningioma risk. Results Among women with UM, the risk of developing meningioma was significantly higher (45%) than among women without UM (95% CI 1.23–1.70). The same phenomenon was observed among most age groups, but a significant difference was only seen in the middle-age range. For women with UM, further analysis did not show a significant change after myomectomy. The cumulative incidence of meningioma between groups with and without UM differed over time. Conclusions The nationwide population-based cohort study found that Taiwanese women with UM are at higher risk for developing meningioma.

scholarly journals Association between Blood Pressure and Serum Thyroid-Stimulating Hormone Concentration within the Reference Range: A Population-Based Study

2007 ◽  
Vol 92 (3) ◽  
pp. 841-845 ◽  
Author(s):  
Bjørn O. Åsvold ◽  
Trine Bjøro ◽  
Tom I. L. Nilsen ◽  
Lars J. Vatten
Keyword(s):  
Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Outcome Measures ◽  
Odds Ratio ◽  
Reference Range ◽  
Positive Association ◽  
Population Based ◽  
Thyroid Stimulating Hormone ◽  
Cross Sectional ◽  
Population Based Study

Abstract Context: The association between thyroid function and blood pressure is insufficiently studied. Objective: The objective of the investigation was to study the association between TSH within the reference range and blood pressure. Design and Setting: This was a cross-sectional, population-based study. Subjects: A total of 30,728 individuals without previously known thyroid disease were studied. Main Outcome Measures: The main outcome measures were mean systolic and diastolic blood pressure and pulse pressure and odds ratio for hypertension (&gt;140/90 mm Hg or current or previous use of antihypertensive medication), according to categories of TSH. Results: Within the reference range of TSH (0.50–3.5 mU/liter), there was a linear increase in blood pressure with increasing TSH. The average increase in systolic blood pressure was 2.0 mm Hg [95% confidence interval (CI) 1.4–2.6 mm Hg] per milliunit per liter increase in TSH among men, and 1.8 mm Hg (95% CI 1.4–2.3 mm Hg) in women. The corresponding increase in diastolic blood pressure was 1.6 mm Hg (95% CI 1.2–2.0 mm Hg) in men and 1.1 mm Hg (95% CI 0.8–1.3 mm Hg) in women. Comparing TSH of 3.0–3.5 mU/liter (upper part of the reference) with TSH of 0.50–0.99 mU/liter (lower part of the reference), the odds ratio for hypertension was 1.98 (95% CI 1.56–2.53) in men and 1.23 (95% CI 1.04–1.46) in women. Conclusion: Within the reference range of TSH, we found a linear positive association between TSH and systolic and diastolic blood pressure that may have long-term implications for cardiovascular health.

Mortality among older Spanish people with hip fractures: a population-based matched cohort study

2021 ◽  
Author(s):  
Alicia Gutiérrez-Misis ◽  
Rocío Queipo ◽  
María Victoria Castell ◽  
Teresa Alarcón ◽  
Rocío Menéndez-Colino ◽  
...  
Keyword(s):  
Cohort Study ◽  
Hip Fractures ◽  
Population Based ◽  
Matched Cohort ◽  
Matched Cohort Study

scholarly journals Association between Anemia and Stroke in Females: A Nationwide, Population-Based Cohort Study in Taiwan

2020 ◽  
Vol 17 (20) ◽  
pp. 7440
Author(s):  
Yuan Sui ◽  
Chien-Tai Hong ◽  
Li-Nien Chien ◽  
Hung-Yi Liu ◽  
Hung-Yi Chiou ◽  
...  
Keyword(s):  
Risk Factor ◽  
Cohort Study ◽  
Ischemic Stroke ◽  
Stroke Risk ◽  
Medical Condition ◽  
Positive Association ◽  
Population Based ◽  
Reproductive Age ◽  
Research Database ◽  
Female Patients

Optimal stroke prevention strategies for women should take into account specific sex-related stroke risk factors. Anemia is a common medical condition in females, particularly in women of reproductive age. This study investigated whether anemia is an independent risk factor for stroke in females in a population-based cohort study. We investigated newly diagnosed anemic female patients with no history of central nervous system disease, psychiatric disorders, traumatic brain injury, major operations or hemorrhagic diseases identified from the Taiwan National Health Insurance Research Database. Non-anemic matched controls (1:1) were selected based on a propensity score estimated using a logistic regression model that included demographic characteristics and comorbidities. A competing risk analysis was applied to estimate the stroke risk in anemic patients compared to that of their matched controls. In our study, the adjusted sub-distribution hazard ratios (aSHRs) of overall, hemorrhagic and ischemic stroke in anemic female patients aged <50 years were 1.35 (95% confidence interval (CI): 1.19–1.52, p < 0.001), 1.31 (95% CI, 1.09-1.56, p < 0.003), and 1.35 (95% CI, 1.15–1.58, p < 0.001), respectively, compared to non-anemic female controls. However, a positive association between anemia and stroke was not found for those aged ≥50 years. Similar results were observed when the follow-up age was limited to 50 years to reduce the potential effects of menopause on stroke. In conclusion, the present population-based cohort study found that anemia is a potential risk factor for overall, hemorrhagic and ischemic stroke in females of reproductive age.

scholarly journals Positive Association of Male Overactive Bladder Symptoms and Androgen Deprivation: A Nationwide Population-based Cohort Study

2018 ◽  
Vol 39 (1) ◽  
pp. 305-311 ◽  
Author(s):  
JIAN-RI LI ◽  
SHIAN-SHIANG WANG ◽  
CHING-HENG LIN ◽  
WILLIAM C. DE GROAT ◽  
CHEN-LI CHENG
Keyword(s):  
Cohort Study ◽  
Overactive Bladder ◽  
Positive Association ◽  
Population Based ◽  
Androgen Deprivation ◽  
Overactive Bladder Symptoms ◽  
Bladder Symptoms

scholarly journals Clinical management of hip fractures in elderly patients with dementia and postoperative 30‐day mortality: A population‐based cohort study

2020 ◽  
Vol 10 (11) ◽  
Author(s):  
Jindong Ding Petersen ◽  
Volkert Dirk Siersma ◽  
Sonja Wehberg ◽  
Connie Thurøe Nielsen ◽  
Bjarke Viberg ◽  
...  
Keyword(s):  
Cohort Study ◽  
Elderly Patients ◽  
Hip Fractures ◽  
Clinical Management ◽  
Population Based
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