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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Impact of age on the importance of systolic and diastolic blood pressures for stroke risk: The MOnica, Risk, Genetics, Archiving, and Monograph (MORGAM) Project
Hypertension, Volume 60, No. 5, Year 2012
Notification
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Description
This study investigates age-related shifts in the relative importance of systolic (SBP) and diastolic (DBP) blood pressures as predictors of stroke and whether these relations are influenced by other cardiovascular risk factors. Using 34 European cohorts from the MOnica, Risk, Genetics, Archiving, and Monograph (MORGAM) Project with baseline between 1982 and 1997, 68 551 subjects aged 19 to 78 years, without cardiovascular disease and not receiving antihypertensive treatment, were included. During a mean of 13.2 years of follow-up, stroke incidence was 2.8%. Stroke risk was analyzed using hazard ratios per 10-mm Hg/5-mm Hg increase in SBP/DBP by multivariate-adjusted Cox regressions, including SBP and DBP simultaneously. Because of nonlinearity, DBP was analyzed separately for DBP <71 mm Hg and DBP <71 mm Hg. Stroke risk was associated positively with SBP and DBP <71 mm Hg (SBP/DBP <71 mm Hg; hazard ratios: 1.15/1.06 [95% CI: 1.12-1.18/1.03-1.09]) and negatively with DBP <71 mm Hg (0.88[0.79-0.98]). The hazard ratio for DBP decreased with age (P<0.001) and was not influenced by other cardiovascular risk factors. Taking into account the age×DBP interaction, both SBP and DBP <71 mm Hg were significantly associated with stroke risk until age 62 years, but in subjects older than 46 years the superiority of SBP for stroke risk exceeded that of DBP <71 mm Hg and remained significant until age 78 years. DBP <71 mm Hg became significant at age 50 years with an inverse relation to stroke risk. In Europeans, stroke risk should be assessed by both SBP and DBP until age 62 years with increased focus on SBP from age 47 years. From age 62 years, emphasis should be on SBP without neglecting the potential harm of very low DBP. © 2012 American Heart Association, Inc.
Authors & Co-Authors
Vishram, Julie Kiranjot Kaur
Denmark, Herning
Cardiovascular Research Unit
Denmark, Glostrup
Amtssygehuset I Glostrup
Borglykke, Anders
Denmark, Glostrup
Amtssygehuset I Glostrup
Andreasen, Anne Helms
Denmark, Glostrup
Amtssygehuset I Glostrup
Jeppesen, Jørgen Lykke
Denmark, Herning
Cardiovascular Research Unit
Ibsen, Hans Henning Windeløv
Denmark
Holbk University Hospital
Jörgensen, Torben J.
Denmark, Glostrup
Amtssygehuset I Glostrup
Broda, Grażyna B.
Poland, Warsaw
Instytut Kardiologii Im. Prymasa Tysiaclecia Stefana Kardynała Wyszynskiego
Palmieri, Luigi
Italy, Rome
Istituto Superiore Di Sanita
Giampaoli, Simona
Italy, Rome
Istituto Superiore Di Sanita
Donfrancesco, Chiara
Italy, Rome
Istituto Superiore Di Sanita
Kee, Frank
United Kingdom, Belfast
Queen's University Belfast
Mancia, Giuseppe
Italy, Milan
Irccs Istituto Auxologico Italiano
Cesana, Giancarlo
Italy, Monza
Azienda Ospedaliera San Gerardo Monza
Kuulasmaa, Kari A.
Finland, Helsinki
Terveyden ja Hyvinvoinnin Laitos
Sans, Susana
Spain, Barcelona
Institut Catala de la Salut
Olsen, Michael Hecht
Denmark, Odense
Odense Universitetshospital
South Africa, Potchefstroom
North-west University
Statistics
Citations: 101
Authors: 16
Affiliations: 12
Identifiers
Doi:
10.1161/HYPERTENSIONAHA.112.201400
ISSN:
0194911X
e-ISSN:
15244563
Research Areas
Environmental
Genetics And Genomics
Noncommunicable Diseases
Study Design
Cohort Study