The association between changes in blood pressure components and incident cardiovascular diseases

Area of Science:

• Cardiology
• Public Health
• Epidemiology

Background:

• Cardiovascular diseases (CVD) remain a leading cause of mortality worldwide.
• Understanding the impact of blood pressure (BP) component changes on CVD incidence is crucial for prevention.
• Previous studies have focused on baseline BP, but the prognostic value of BP component *changes* requires further investigation.

Purpose of the Study:

• To investigate the association between changes in systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and pulse pressure (PP) between two visits.
• To determine if these BP component changes predict incident cardiovascular diseases (CVD) in an adult population.

Main Methods:

• A cohort of 3569 Iranian adults (≥30 years) had BP components measured at baseline (1999-2001) and a second visit (2002-2005).
• Subjects were followed for incident CVD events.
• Multivariate Cox proportional-hazards models were used to assess the risk associated with BP component changes, adjusting for baseline BP, cardiovascular risk factors, and their changes.

Main Results:

• During a median follow-up of 6.09 years, 303 CVD cases occurred.
• A one standard deviation increase in SBP, DBP, and MAP was significantly associated with increased CVD risk (21%, 22%, and 95% respectively, p<0.05).
• The association of DBP change with CVD remained significant even after adjusting for SBP changes (HR 1.21, 95% CI 1.05-1.39). PP change was not significantly associated with CVD.

Conclusions:

• Increases in SBP, DBP, and MAP over a three-year period are associated with higher incident CVD risk in middle-aged adults.
• Diastolic blood pressure changes independently predict cardiovascular events, irrespective of systolic blood pressure changes.
• Pulse pressure changes did not show a significant association with incident CVD in this cohort.