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Impact of blood pressure and blood pressure change during middle age on the remaining lifetime risk for
Norrina Allen1, Jarett D Berry, Hongyan Ning
1Department of Preventive Medicine and Division of Cardiology, Feinberg School of Medicine, Northwestern University, 680 N Lake Shore Dr, Ste 1102, Chicago, IL 60611, USA.
Circulation
|December 21, 2011
Summary
Changes in blood pressure (BP) during middle age significantly impact lifetime risk (LTR) for cardiovascular disease (CVD). Maintaining normal BP lowers CVD risk, while developing hypertension increases it.
Area of Science:
- Cardiovascular epidemiology
- Public health
- Gerontology
Background:
- Previous lifetime risk (LTR) estimates for cardiovascular disease (CVD) did not account for dynamic changes in blood pressure (BP) over time.
- This study investigates the influence of evolving BP levels during middle age on long-term CVD risk.
Purpose of the Study:
- To assess how changes in blood pressure (BP) throughout middle age affect the lifetime risk (LTR) for cardiovascular disease (CVD), coronary heart disease, and stroke.
- To provide updated LTR estimates that incorporate dynamic BP changes.
Main Methods:
- Pooled data from 7 diverse U.S. cohort studies, including 61,585 individuals followed for 700,000 person-years.
- Estimated remaining LTR for CVD, coronary heart disease, and stroke for white and black men and women, accounting for death from CVD as a competing risk.
- Analyzed LTR by baseline BP strata and by changes in BP over an average of 14 years, starting at age 55.
Main Results:
- Overall LTR for CVD was 52.5% for men and 39.9% for women.
- Higher LTR for CVD was observed in Black individuals and increased with higher baseline BP.
- Individuals maintaining or lowering BP to normal levels by age 55 had significantly lower remaining LTR (22%-41%) compared to those with hypertension (42%-69%).
Conclusions:
- Changes in blood pressure (BP) during middle age are directly associated with subsequent lifetime risk (LTR) for cardiovascular disease (CVD).
- Efforts to lower BP and prevent or delay hypertension onset are crucial for reducing long-term CVD risk.
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