OBJECTIVE: To study the association between blood pressure and change in blood pressure with future coronary risk among elderly men. DESIGN: Cohort study. SETTING: Finnish cohorts of the Seven Countries Study. PARTICIPANTS: Four hundred and seventy-six men aged 65-84 years and free of clinically manifested coronary heart disease at baseline, in 1984. MAIN OUTCOME MEASURES: Fatal myocardial infarction (n = 29), any myocardial infarction (n = 42), and incidence of any new signs and symptoms of coronary heart disease (n = 80) during a 5-year follow-up. RESULTS: In multivariate analysis, a significant inverse U-shaped relationship was observed between baseline diastolic blood pressure and future fatal myocardial infarction, any myocardial infarction and any coronary heart disease. In models predicting the risk of coronary heart disease during 1984-1989, there was a significant interaction between both systolic (SBP) and diastolic blood pressure (DBP) in 1969-1974 and change in blood pressure between 1969-1974 and 1984. In categorical analyses, men (n = 42) who experienced a decline in DBP of > or = 4 mmHg from initial levels of > or = 90 mmHg had a higher risk of any myocardial infarction than men (n = 112) with a change of < 4 mmHg (odds ratio 4.5). For a decline of > or = 10 mmHg or more in SBP from levels of > or = 160 mmHg the corresponding odds ratio was 2.9. Men who experienced a decline in DBP or SBP from normotensive levels or an increase in blood pressure had no excess risk compared with men with stabile (change in DBP < 4 mmHg and change in SBP < 10 mmHg) blood pressure values. CONCLUSION: The present results suggest that among elderly men a decline in DBP or SBP from previously hypertensive levels may be associated with increased coronary risk.
OBJECTIVE: To study the association between blood pressure and change in blood pressure with future coronary risk among elderly men. DESIGN: Cohort study. SETTING: Finnish cohorts of the Seven Countries Study. PARTICIPANTS: Four hundred and seventy-six men aged 65-84 years and free of clinically manifested coronary heart disease at baseline, in 1984. MAIN OUTCOME MEASURES: Fatal myocardial infarction (n = 29), any myocardial infarction (n = 42), and incidence of any new signs and symptoms of coronary heart disease (n = 80) during a 5-year follow-up. RESULTS: In multivariate analysis, a significant inverse U-shaped relationship was observed between baseline diastolic blood pressure and future fatal myocardial infarction, any myocardial infarction and any coronary heart disease. In models predicting the risk of coronary heart disease during 1984-1989, there was a significant interaction between both systolic (SBP) and diastolic blood pressure (DBP) in 1969-1974 and change in blood pressure between 1969-1974 and 1984. In categorical analyses, men (n = 42) who experienced a decline in DBP of > or = 4 mmHg from initial levels of > or = 90 mmHg had a higher risk of any myocardial infarction than men (n = 112) with a change of < 4 mmHg (odds ratio 4.5). For a decline of > or = 10 mmHg or more in SBP from levels of > or = 160 mmHg the corresponding odds ratio was 2.9. Men who experienced a decline in DBP or SBP from normotensive levels or an increase in blood pressure had no excess risk compared with men with stabile (change in DBP < 4 mmHg and change in SBP < 10 mmHg) blood pressure values. CONCLUSION: The present results suggest that among elderly men a decline in DBP or SBP from previously hypertensive levels may be associated with increased coronary risk.
Authors: Christopher C Smitson; Rebecca Scherzer; Michael G Shlipak; Bruce M Psaty; Anne B Newman; Mark J Sarnak; Michelle C Odden; Carmen A Peralta Journal: Am J Hypertens Date: 2017-06-01 Impact factor: 2.689
Authors: Martin Bahls; Matthias W Lorenz; Marcus Dörr; Lu Gao; Kazuo Kitagawa; Tomi-Pekka Tuomainen; Stefan Agewall; Gerald Berenson; Alberico L Catapano; Giuseppe D Norata; Michiel L Bots; Wiek van Gilst; Folkert W Asselbergs; Frank P Brouwers; Heiko Uthoff; Dirk Sander; Holger Poppert; Michael Hecht Olsen; Jean Philippe Empana; Ulf Schminke; Damiano Baldassarre; Fabrizio Veglia; Oscar H Franco; Maryam Kavousi; Eric de Groot; Ellisiv B Mathiesen; Liliana Grigore; Joseph F Polak; Tatjana Rundek; Coen DA Stehouwer; Michael R Skilton; Apostolos I Hatzitolios; Christos Savopoulos; George Ntaios; Matthieu Plichart; Stela McLachlan; Lars Lind; Peter Willeit; Helmuth Steinmetz; Moise Desvarieux; M Arfan Ikram; Stein Harald Johnsen; Caroline Schmidt; Johann Willeit; Pierre Ducimetiere; Jackie F Price; Göran Bergström; Jussi Kauhanen; Stefan Kiechl; Matthias Sitzer; Horst Bickel; Ralph L Sacco; Albert Hofman; Henry Völzke; Simon G Thompson Journal: Eur J Prev Cardiol Date: 2019-10-16 Impact factor: 7.804