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Average blood pressure and cardiovascular disease-related mortality in middle-aged women

Marijke J C A van Trijp1, Diederick E Grobbee, Petra H M Peeters

  • 1Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.

American Journal of Hypertension
|March 9, 2005
PubMed

Insights

Systolic blood pressure (SBP) and mean arterial pressure (MAP) showed the strongest association with cardiovascular disease (CVD) mortality in postmenopausal women. The relationship did not change over time.

Area of Science:

  • Cardiovascular epidemiology
  • Geriatric medicine
  • Hypertension research

Background:

  • Cardiovascular disease (CVD) remains a leading cause of mortality in postmenopausal women.
  • Identifying specific blood pressure (BP) components most predictive of CVD risk is crucial for targeted prevention strategies.
  • Previous research has yielded mixed results regarding which BP parameter holds the strongest prognostic value.

Purpose of the Study:

  • To determine which average blood pressure component (systolic BP [SBP], diastolic BP [DBP], pulse pressure [PP], or mean arterial pressure [MAP]) is most strongly associated with CVD-related mortality.
  • To investigate whether the strength of this association varies with different follow-up durations.

Main Methods:

  • Prospective cohort study of 7813 postmenopausal women aged 49-66 years.
  • Utilized four BP measurements per participant, averaged to derive mean SBP, DBP, PP, and MAP.
  • Employed Cox proportional hazards models, adjusting for key risk factors, and analyzed results stratified by follow-up time (10, 15, 20 years).

Main Results:

  • During a mean follow-up of 13.1 years, 463 CVD-related deaths occurred.
  • Systolic blood pressure (SBP) and mean arterial pressure (MAP) demonstrated the highest hazard ratios (HR) for CVD mortality (HR=1.43 for both).
  • Confidence intervals for all BP components overlapped, indicating no statistically significant difference in their association strength with CVD mortality; no variation was observed across follow-up strata.

Conclusions:

  • In postmenopausal women, both SBP and MAP appear to be the most significant predictors of CVD-related mortality.
  • Despite higher HRs, the overlapping confidence intervals suggest SBP and MAP are not definitively superior to DBP or PP in predicting CVD death.
  • The predictive power of these BP components for CVD mortality does not appear to diminish or increase with longer follow-up periods.
Abstract

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