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Systolic blood pressure (SBP) is a superior predictor of stroke and mortality in older Europeans, especially when combined with other cardiovascular risk factors. Metabolic syndrome (MetS) prevalence and impact vary significantly by age and gender, posing higher risks for women.

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Area of Science:

  • Cardiology
  • Epidemiology
  • Public Health

Background:

  • Cardiovascular disease (CVD) is a leading global cause of death, with hypertension and metabolic syndrome (MetS) being significant risk factors.
  • Europe faces a high prevalence of hypertension and MetS, yet risk factor control remains suboptimal.
  • Understanding the interplay of cardiovascular risk factors, particularly systolic blood pressure (SBP) and MetS, is crucial for effective primary prevention strategies.

Purpose of the Study:

  • To investigate the age-related superiority of SBP over diastolic blood pressure (DBP) as a cardiovascular risk factor.
  • To determine how other cardiovascular risk factors influence the age at which SBP becomes the dominant predictor.
  • To examine the prevalence and prognostic significance of MetS across different age groups and genders.

Main Methods:

  • Analysis of 34-42 cohorts from the MORGAM Project (approx. 68,000-86,000 participants) with 12-13 years of follow-up.
  • Multivariate-adjusted Cox regressions used to analyze event risk, including SBP, DBP, and interactions.
  • MetS prevalence and prognostic significance assessed using modified IDF and NCEP-ATP III criteria, with analyses stratified by age and gender.

Main Results:

  • SBP superiority as a risk factor for stroke and all-cause mortality emerged in the 6th decade, influenced by other risk factors for stroke mortality.
  • A potential harmful effect of low DBP was observed for total stroke and all-cause mortality from mid-age onwards.
  • MetS prevalence increased with age (5-fold in women, 2-fold in men) and its CVD risk was higher in women, particularly by NCEP-ATP III criteria.

Conclusions:

  • SBP is independently superior to DBP in predicting cardiovascular events in elderly Europeans, with this effect on stroke mortality appearing earlier when other risk factors are present.
  • MetS prevalence and its associated cardiovascular risk vary significantly by age and gender.
  • In women, MetS is linked to higher relative event risks, and this risk for coronary heart disease decreases with age.