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Secular decrease in blood pressure and reduction in mortality from cardiovascular disease in Israeli workers.

P Froom1, U Goldbourt

  • 1Department of Epidemiology and Preventive Medicine, Sackler School of Medicine, Tel-Aviv University, Israel. paulfr@ioh.org.il

Journal of Human Hypertension
|January 20, 2004
PubMed
Summary
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Declining blood pressure significantly reduced cardiovascular disease (CVD) mortality. This study found lower blood pressure in a later cohort explained the decrease in CVD deaths over 24 years.

Area of Science:

  • Epidemiology
  • Cardiovascular Medicine
  • Public Health

Background:

  • The causes of reduced cardiovascular disease (CVD) mortality since the 1970s are not fully understood.
  • This study investigates mortality trends in two male cohorts separated by 24 years.

Purpose of the Study:

  • To compare cardiovascular and all-cause mortality rates between two employed male cohorts.
  • To identify factors contributing to the decline in CVD mortality over time.

Main Methods:

  • Comparison of mortality rates over 11 years in two cohorts (1963 civil servants, 1985-1987 industrial workers).
  • Assessment of blood pressure and other CVD risk markers at cohort inception.
  • Statistical analysis of hazard ratios for CVD and all-cause mortality.

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Main Results:

  • The earlier cohort (1963) had higher mean systolic blood pressure (SBP) by 8.7 mmHg compared to the later cohort (1987).
  • Higher SBP in the 1963 cohort was associated with increased CVD mortality (HR 1.47).
  • Adjusting for SBP reduced the CVD mortality hazard ratio in the 1963 cohort to 1.18, indicating its significant impact.

Conclusions:

  • Declining blood pressure is a key factor explaining the observed decrease in CVD mortality over 24 years.
  • Blood pressure reduction appears to be a major driver of secular trends in cardiovascular health.