Systolic Blood Pressure as an Independent Predictor of Mortality in the Hypertension Detection and Follow-up Program

Abernethy, John; Borhani, Nemat O.; Hawkins, C. Morton; Crow, Richard S.; Entwisle, George; Jones, John W.; Maxwell, Morton H.; Langford, Herbert G.; Pressel, Sara L.

doi:10.1016/s0749-3797(18)31337-0

Cited by 51 publications

(22 citation statements)

References 31 publications

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“…30 The Hypertension Detection and Follow-up Program reported that all-cause mortality increased by 11% per 10-mm Hg increment in PP compared with 8 and 5% for similar increases in systolic and diastolic BP, respectively. 31 Blacher et al 32 also reported that an increase of 10 mm Hg in PP increased the risk of major cardiovascular complications, with the increase in risk ranging from nearly 13% for all coronary end points to 20% for cardiovascular mortality. In our previous review, 4 both systolic and diastolic BP levels were higher among African descent populations than their White counterparts.…”

Section: Discussion Of Key Findingsmentioning

confidence: 98%

Does the pulse pressure in people of European, African and South Asian descent differ? A systematic review and meta-analysis of UK data

2007

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The aim of this study was to assess whether the pulse pressures (PPs) in people of African and South Asian descent differ from those of the European-origin White (henceforth, White) in the UK. A systematic literature review was carried out using MEDLINE 1966-2006 and EMBASE 1980-2006. The meta-analysis was performed using Cochrane review manager software (RevMan version 4.2; Oxford, UK). Thirteen studies were examined. Results for African descent men (n ¼ 9 studies) and women (n ¼ 7) indicated that African men and women had a higher mean PP than their White counterparts. Overall weighted mean difference (WMD)

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Section: Discussion Of Key Findingsmentioning

confidence: 98%

Does the pulse pressure in people of European, African and South Asian descent differ? A systematic review and meta-analysis of UK data

2007

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“…An analysis of data from the Hypertension Detection Follow-Up Program reported by Abernathy et al 27 incorporated other available cardiovascular risk factors into a logistic regression model, demonstrating that pulse pressure is a significant predictor of mortality in that cohort. In 1989, Darne et al 8 reported their study of 27 000 French subjects in whom pulse pressure was associated with cardiovascular death independent of other known risk factors, including diastolic and mean arterial pressures.…”

Section: Comparison With Other Studiesmentioning

confidence: 99%

Cardiovascular Risk Assessment Using Pulse Pressure in the First National Health and Nutrition Examination Survey (NHANES I)

Domanski

Norman²,

Wolz³

et al. 2001

Hypertension

165

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Abstract-Increased stiffness of the conduit arteries has been associated with increased risk of death and cardiovascular death in a number of populations. None of these populations, however, are fully representative of the US population. The cohort examined in the First National Health and Nutrition Examination Survey (NHANES I) that was free of overt cardiovascular disease was selected to be representative of the US population. We assessed and quantified the increased risk of death associated with elevated pulse pressure in this population. A cohort of 5771 subjects from NHANES I was used to determine the value of adding pulse pressure to standard cardiovascular disease risk factors for assessment of the risk of death during a mean follow-up period of 16.5 years. Analyses were performed by use of the SUDAAN statistical package for performing Cox proportional regression, logistic regression, and other standard methods in complex, weighted samples. Pulse pressure increased with increasing age, body mass index, cholesterol level, and mean arterial pressure. With increasing pulse pressure, the percentage of cigarette smokers decreased and the percentage of diabetics increased. Despite these associations with known risk factors, pulse pressure was independently predictive of an increased risk of death from cardiovascular disease, coronary heart disease, and all-cause mortality. It provides independent prognostic information beyond that provided by known risk factors that were evaluated in this study, including the Sixth Joint National Committee on Prevention, Detection, Evaluation,

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“…The Hypertension Detection and Follow-up Program (HDFP) findings demonstrate that the predictive power of PP was similar to that of systolic BP. 19 The Multiple Risk Factor Intervention Trial (MRFIT), although not specifically in the elderly, recently confirmed that systolic and diastolic BPs are better predictors of cardiovascular disease-related mortality than PP. 20 These studies did not examine mean BP, which along with systolic BP was a good predictor in our study.…”

Section: Nih-pa Author Manuscriptmentioning

confidence: 99%

Comparison of usefulness of systolic, diastolic, and mean blood pressure and pulse pressure as predictors of cardiovascular death in patients ≥60 years of age (The Dubbo Study)

Palaniappan

Simons

et al. 2002

The American Journal of Cardiology

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Blood pressure (BP) is an important predictor of future cardiovascular risk. Clinicians have traditionally recognized the importance of systolic BP, especially in older adults. 1 BP is also characterized by its pulsatile (estimated by pulse pressure [PP]) and steady (estimated by mean arterial pressure) components. 2 Two recent studies 3,4 have emphasized the importance of PP, defined as systolic BP minus diastolic BP, as a predictor of cardiovascular events or mortality in the elderly. Another study 5 highlighted mean BP, defined as 1/3 systolic BP plus 2/3 diastolic BP, as a predictor of cardiovascular disease risk. Data from the Framingham Heart Study 6 and other studies 7 indicate that systolic BP increases continuously with age, whereas diastolic BP increases until age 60 years and then begins to decrease steadily. As a result, PP may become a more important BP measurement associated with cardiovascular disease in older persons. 8 Darne et al 2 were among the first to report that PP, in addition to mean BP, was an independent cardiovascular risk factor. Mean BP has not been as extensively studied, with positive associations with cardiovascular disease in some 5,9,10 but not all 11 studies. It remains unclear which measures of BP, either alone or in combination, best predict the risk of cardiovascular disease mortality. Therefore, we studied the use of systolic BP, diastolic BP, PP, and mean BP in an elderly cohort of men and women aged ≥60 years at baseline with no history of cardiovascular disease. Using BP values at baseline, we compared the associations of each BP measure with the risk of cardiovascular disease mortality prospectively over 12 to 13 years of follow-up.The Dubbo Study is an ongoing prospective study in an elderly Australian cohort first examined in 1988. 12 All noninstitutionalized residents of the semi-urban town of Dubbo, New South Wales, born before 1930 were eligible; the participation rate was 73%, with an ultimate cohort of 2,805 men and women. Methods and measures have already been described in detail. 12 Briefly, the baseline examinations consisted of demographic, psychosocial, and standard cardiovascular risk assessment. Two BP readings were obtained after 10 minutes of seated rest, using phase V as diastolic. The second of these 2 readings was used in the present analyses. The study was approved and reapproved by institutional ethics committees at St. Vincent's Hospital Sydney, the University of New South Wales (Sydney, Australia), and the Australian National University (Canberra, Australia). All participants gave written informed consent. NIH Public Access Author ManuscriptAm J Cardiol. Author manuscript; available in PMC 2011 July 1. Outcomes until September 2001 are included in the present analysis. Hospitalization and death records were monitored continuously, and postal surveys were conducted every 2 years to confirm vital status. The most recent survey successfully traced >95% of the surviving participants. Records were coded according to the International Classification o...

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Systolic Blood Pressure as an Independent Predictor of Mortality in the Hypertension Detection and Follow-up Program

Cited by 51 publications

References 31 publications

Does the pulse pressure in people of European, African and South Asian descent differ? A systematic review and meta-analysis of UK data

Does the pulse pressure in people of European, African and South Asian descent differ? A systematic review and meta-analysis of UK data

Cardiovascular Risk Assessment Using Pulse Pressure in the First National Health and Nutrition Examination Survey (NHANES I)

Comparison of usefulness of systolic, diastolic, and mean blood pressure and pulse pressure as predictors of cardiovascular death in patients ≥60 years of age (The Dubbo Study)

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