Vishram-Nielsen, J.K.K.* ; Kristensen, A.M.D.* ; Pareek, M.* ; Laurent, S.* ; Nilsson, P.M.* ; Linneberg, A.* ; Greve, S.V.* ; Palmieri, L.* ; Giampaoli, S.* ; Donfrancesco, C.* ; Kee, F.* ; Mancia, G.* ; Cesana, G.* ; Veronesi, G.* ; Grassi, G.* ; Kuulasmaa, K.* ; Salomaa, V.* ; Palosaari, T.* ; Sans, S.* ; Ferrieres, J.* ; Dallongeville, J.* ; Söderberg, S.* ; Moitry, M.* ; Drygas, W.* ; Tamosiunas, A.* ; Peters, A. ; Brenner, H.* ; Grimsgaard, S.* ; Savallampi, M.* ; Olsen, M.H.*
Predictive importance of blood pressure characteristics with increasing age in healthy men and women: The MORGAM Project.
Hypertension 77, 1076-1085 (2021)
It remains unclear which blood pressure (BP) characteristics best predict cardiovascular risk in different age groups and between sexes. We leveraged data from the MORGAM (MONICA [Monitoring of Trends and Determinants in Cardiovascular Disease], Risk, Genetics, Archiving and Monograph) Project to investigate determinants of BP characteristics and their prognostic importance, in younger and older (P interaction <0.001). Higher systolic BP and mean BP were significantly associated with cardiovascular end point, irrespective of age group (P<0.001), but diastolic BP only demonstrated an independent relationship in the younger group (P<0.001). Brachial pulse pressure was associated with cardiovascular end point in the older age group (P<0.001). In subjects <50 years, diastolic BP significantly improved area under the receiver operating characteristic curve compared with Systematic Coronary Risk Evaluation variables (including systolic BP) alone (0.842 versus 0.840, P=0.03), enhanced continuous net reclassification improvement (0.150 [95% CI, 0.087-0.215]) and improved the prognostic value of the European Society of Cardiology/European Society of Hypertension hypertension definition (categorical net reclassification improvement=0.0255, P=0.005). In conclusion, diastolic BP may provide additional prognostic utility beyond systolic BP, in predicting composite cardiovascular events among younger individuals.
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Blood Pressure ; Cardiovascular Disease ; Myocardial Infarction ; Prognosis ; Risk Factor
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0194-911x
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1524-4563
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Volume: 77,
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Pages: 1076-1085
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Lippincott Williams & Wilkins
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Two Commerce Sq, 2001 Market St, Philadelphia, Pa 19103 Usa
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Peer reviewed
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Institute of Epidemiology (EPI)
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County council of Vastertbotten
Swedish Heart and Lung Foundation
Finnish Foundation for Cardiovascular research
BiomarCaRE
European Community FP 7 projects Consortium on Health and Ageing: Network of cohorts in Europe and the United States