Dataset Information

Short-Term and Long-Term Blood Pressure Changes and the Risk of All-Cause and Cardiovascular Mortality.

ABSTRACT:

Background

Few studies compared the effects of BP changes in short- and long-terms on all-cause mortality and CVD mortality.

Methods

We performed a 12.5-year follow-up study to examine the association between short- (2008 to 2010) and long-term [baseline (2004-2006) to 2010] BP changes and the risk of mortality (2010 to 2017) in the Fuxin prospective cohort study. The Cox proportional hazards model was used for this study, and the average BP was stratified according to the Seven Joint National Committee (JNC7).

Results

We identified 1496 (805 CVD deaths) and 2138 deaths (1222 CVD deaths) in short- and long-term study. Compared with BP maintainer, in short-term BP changes, for participants from normotension or prehypertension to hypertension, the hazards ratios (HRs) and 95% confidence intervals (CIs) of all-cause mortality were 1.948 (1.118-3.392) and 1.439 (1.218-1.700), respectively, while for participants from hypertension to prehypertension, the HRs (95% CIs) were 0.766 (0.638-0.899) for all-cause mortality and 0.729 (0.585-0.908) for CVD mortality, respectively. In long-term BP changes, for participants from normotension or prehypertension to hypertension, the HRs (95% CIs) of all-cause mortality were 1.738 (1.099-2.749) and 1.203 (1.023-1.414), and they were 2.351 (1.049-5.269) and 1.323 (1.047-1.672) for CVD mortality, respectively. In addition, the effects of short-term BP changes on all-cause and CVD mortality, measured as regression coefficients (?), were significantly greater than those in long-term change (all P<0.05).

Conclusions

Our study emphasizes that short-term changes in BP have a greater impact on all-cause and CVD mortality than long-term changes and assess the cut-off value of the changes in blood pressure elevation.

SUBMITTER: Dai Y

PROVIDER: S-EPMC6699331 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Publications

Short-Term and Long-Term Blood Pressure Changes and the Risk of All-Cause and Cardiovascular Mortality.

Dai Yue Y Wang Yali Y Xie Yanxia Y Zheng Jia J Guo Rongrong R Sun Zhaoqing Z Xing Liying L Zhang Xingang X Sun Yingxian Y Zheng Liqiang L

BioMed research international 20190806

<h4>Background</h4>Few studies compared the effects of BP changes in short- and long-terms on all-cause mortality and CVD mortality.<h4>Methods</h4>We performed a 12.5-year follow-up study to examine the association between short- (2008 to 2010) and long-term [baseline (2004-2006) to 2010] BP changes and the risk of mortality (2010 to 2017) in the Fuxin prospective cohort study. The Cox proportional hazards model was used for this study, and the average BP was stratified according to the Seven J ...[more]

PMID: 31467896

Similar Datasets

Project description:ImportanceLong-term cumulative systolic blood pressure (SBP) is significantly associated with increased rates of atherosclerotic cardiovascular disease (ASCVD) development independent of single SBP levels. However, published ASCVD risk prediction algorithms only include currently measured SBP.ObjectiveTo determine whether including long-term (5- and 10-year) cumulative SBP in risk equations improves the predictive ability compared with single SBP measurements.Design, setting, and participantsAdults aged 45 to 65 years at the time of risk estimation with at least 20 years of follow-up (5 and 10 years prior to risk estimation and 10 years of event follow-up). The Lifetime Risk Pooling Project included data from the following cohorts: Coronary Artery Risk Development in Young Adults Study, Atherosclerosis Risk in Communities Study, and Framingham Heart Study (both the original and offspring).ExposuresTen-year ASCVD risk, calculated using the approach of the 2013 American College of Cardiology/American Heart Association 10-year ASCVD risk equations, first with current SBP and then substituting 5- and 10-year cumulative SBP levels.Main outcomes and measuresIncident ASCVD events that occurred over 10 years of follow-up, compared with the predicted risks, using the C statistic, net reclassification index at event rate, and the integrated discrimination index.ResultsThis study included 11 767 participants with a mean (SD) age of 59.1 (4.7) years at risk estimation. A total of 6873 participants (58%) were women, and 1499 (13%) were African American. In the 10 years of follow-up from risk estimation, 1887 participants (16%) had an ASCVD event. There were no significant improvements in the C statistic when including 5- or 10-year cumulative SBP. However, the addition of cumulative SBP resulted in significant improvements in the net reclassification index at event rate (10-year net reclassification index for men, 0.04 [95% CI, 0.02-0.06]; 10-year net reclassification index for women, 0.03 [95% CI, 0.01-0.06]) and the relative integrated discrimination index (10-year relative integrated discrimination index for men, 0.12; 10-year relative integrated discrimination index for women, 0.10).Conclusions and relevanceUsing long-term measures of cumulative blood pressure, instead of single measurements, can modestly improve the ability of cardiovascular disease risk prediction models to correctly classify individuals in terms of their risk for cardiovascular disease.

Dataset Information

Short-Term and Long-Term Blood Pressure Changes and the Risk of All-Cause and Cardiovascular Mortality.

Background

Methods

Results

Conclusions

Publications

Short-Term and Long-Term Blood Pressure Changes and the Risk of All-Cause and Cardiovascular Mortality.

Similar Datasets

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