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Longitudinal Patterns of Change in Systolic Blood Pressure and Incidence of Cardiovascular Disease: The Atherosclerosis Risk in Communities Study.

TitleLongitudinal Patterns of Change in Systolic Blood Pressure and Incidence of Cardiovascular Disease: The Atherosclerosis Risk in Communities Study.
Publication TypeJournal Article
Year of Publication2016
AuthorsPetruski-Ivleva N, Viera AJ, Shimbo D, Muntner P, Avery CL, Schneider ALC, Couper DJ
Secondary AuthorsKucharska-Newton AMaria
JournalHypertension
Volume67
Issue6
Pagination1150-6
Date Published2016 06
ISSN1524-4563
KeywordsAge Distribution, Blood Pressure Determination, Cardiovascular Diseases, Coronary Artery Disease, Cross-Sectional Studies, Female, Follow-Up Studies, Humans, Hypertension, Incidence, Longitudinal Studies, Male, Middle Aged, Risk Assessment, Sex Distribution, Survival Rate, Systole, Time Factors
Abstract

Elevated blood pressure in midlife contributes significantly to the risk of cardiovascular disease. However, patterns of blood pressure increase may differ among individuals and may result in differential risk. Our goal was to examine the contribution of longitudinal patterns of blood pressure change to incidence of heart failure, coronary heart disease, stroke, and cardiovascular disease mortality. Latent class growth models were used to identify patterns of change in blood pressure across 4 clinical examinations (1987-1998) among 9845 Atherosclerosis Risk in Communities (ARIC) cohort participants (mean age, 53.7 [SD 5.7] years). Patterns of change in systolic blood pressure included slowly and steeply increasing, a decreasing and a sustained elevated blood pressure. Changes in diastolic and mid-blood pressure (½ systolic+½ diastolic) were less pronounced. The association of blood pressure pattern group membership with incidence of clinical outcomes was examined in follow-up from the fourth clinical examination (1996-1998) to December 31, 2011, using Poisson regression models adjusted for demographic and metabolic characteristics, and hypertension medication use. A gradient of rates of all events was observed across the identified patterns. Associations were attenuated after adjustment for covariates. Cumulative systolic blood pressure load, rather than the temporal pattern of change in systolic blood pressure itself, plays a role in determining the risk of cardiovascular disease, in particular, of heart failure and cardiovascular disease mortality, independent of blood pressure level measured at one point in time.

DOI10.1161/HYPERTENSIONAHA.115.06769
Alternate JournalHypertension
PubMed ID27045024
PubMed Central IDPMC4865423
Grant ListHHSN268201100012C / HL / NHLBI NIH HHS / United States
HHSN268201100009I / HL / NHLBI NIH HHS / United States
HHSN268201100010C / HL / NHLBI NIH HHS / United States
HHSN268201100008C / HL / NHLBI NIH HHS / United States
HHSN268201100005G / HL / NHLBI NIH HHS / United States
HHSN268201100008I / HL / NHLBI NIH HHS / United States
HHSN268201100007C / HL / NHLBI NIH HHS / United States
N01 HC055018 / HC / NHLBI NIH HHS / United States
HHSN268201100011I / HL / NHLBI NIH HHS / United States
HHSN268201100011C / HL / NHLBI NIH HHS / United States
P30 DK079626 / DK / NIDDK NIH HHS / United States
HHSN268201100006C / HL / NHLBI NIH HHS / United States
HHSN268201100005I / HL / NHLBI NIH HHS / United States
HHSN268201100009C / HL / NHLBI NIH HHS / United States
HHSN268201100005C / HL / NHLBI NIH HHS / United States
HHSN268201100007I / HL / NHLBI NIH HHS / United States
K24 HL125704 / HL / NHLBI NIH HHS / United States
P2C HD050924 / HD / NICHD NIH HHS / United States
T32 HL007055 / HL / NHLBI NIH HHS / United States