Systolic blood pressure and vascular disease in men aged 65 years and over - The HIMS (Health in Men Study)

Lacey, Ben, Golledge, Jonathan, Yeap, Bu B., Lewington, Sarah, Mccaul, Kieran A., Norman, Paul, Flicker, Leon, Almeida, Osvaldo P., and Hankey, Graeme J. (2017) Systolic blood pressure and vascular disease in men aged 65 years and over - The HIMS (Health in Men Study). Hypertension, 69 (6). pp. 1053-1059.

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Abstract

There is uncertainty about the relation between blood pressure and vascular disease at older age. We assessed the association of systolic blood pressure (SBP) and major vascular events in a prospective cohort study of 7564 men aged 65 to 94 years, recruited in 1996-1999 from the general population in Perth, Western Australia. SBP was measured at baseline and again at resurvey in 2001-2004. Participants were monitored for fatal and nonfatal vascular events. To limit the effect of reverse causality, analyses were restricted to men without previous vascular disease at baseline. Hazard ratios were estimated by Cox regression, with adjustment for age and education (further adjustment did not materially change the associations). During a mean follow-up of 11 years, there were 1557 major vascular events. Continuous log-linear associations were found between usual SBP and risk of major vascular events throughout the SBP range examined (145170 mm Hg). Overall, 10 mm Hg higher usual SBP was associated with approximate to 20% higher risk of major vascular events (hazard ratio, 19%; 95% confidence interval, 13%-26%; mean age at event 80 years). There was evidence of positive associations with both ischemic heart disease and stroke and effect modification by age, with shallower associations at older ages. Even at 85 to 94 years, however, there was evidence of a positive association: 10 mm Hg higher usual SBP was associated with 14% (95% confidence interval, 1%-30%) higher risk of major vascular events.

Item ID: 50324
Item Type: Article (Research - C1)
ISSN: 1524-4563
Keywords: blood pressure, elderly, epidemiology, hypertension, vascular diseases
Funders: Sylvia and Charles Viertel Charitable Foundation (SCVCF), National Health and Medical Research Council (NHMRC), Queensland Government, Townsville Hospital Private Practice Trust, UK Medical Research Council (MRC), National Heart Foundation, Western Australian Health Promotion Foundation, Freemantle Hospital Medical Research Foundation
Projects and Grants: SCVCF Clinical Investigator Award, NHMRC 1079369, NHMRC 1079193, NHMRC 1063476, NHMRC 1022752, NHMRC 1003707, NHMRC 1021416, NHMRC 1000967, NHMRC 1019921, NHMRC 964145, NHMRC 139093, NHMRC 403963, NHMRC 455811, NHMRC 1045710, NHMRC 1060557
Date Deposited: 20 Sep 2017 07:53
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1102 Cardiovascular Medicine and Haematology > 110201 Cardiology (incl Cardiovascular Diseases) @ 100%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920103 Cardiovascular System and Diseases @ 100%
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