Ten-year blood pressure trajectories, cardiovascular mortality, and life years lost in 2 extinction cohorts: the Minnesota Business and Professional Men Study and the Zutphen Study.

Abstract

BACKGROUND:

Blood pressure (BP) trajectories derived from measurements repeated over years have low measurement error and may improve cardiovascular disease prediction compared to single, average, and usual BP (single BP adjusted for regression dilution). We characterized 10-year BP trajectories and examined their association with cardiovascular mortality, all-cause mortality, and life years lost.

METHODS AND RESULTS:

Data from 2 prospective and nearly extinct cohorts of middle-aged men—the Minnesota Business and Professional Men Study (n=261) and the Zutphen Study (n=632)—were used. BP was measured annually during 1947-1957 in Minnesota and 1960-1970 in Zutphen. BP trajectories were identified by latent mixture modeling. Cox proportional hazards and linear regression models examined BP trajectories with cardiovascular mortality, all-cause mortality, and life years lost. Associations were adjusted for age, serum cholesterol, smoking, and diabetes mellitus. Mean initial age was about 50 years in both cohorts. After 10 years of BP measurements, men were followed until death on average 20 years later. All Minnesota men and 98% of Zutphen men died. Four BP trajectories were identified, in which mean systolic BP increased by 5 to 49 mm Hg in Minnesota and 5 to 20 mm Hg in Zutphen between age 50 and 60. The third systolic BP trajectories were associated with 2 to 4 times higher cardiovascular mortality risk, 2 times higher all-cause mortality risk, and 4 to 8 life years lost, compared to the first trajectory.

CONCLUSIONS:

Ten-year BP trajectories were the strongest predictors, among different BP measures, of cardiovascular mortality, all-cause mortality, and life years lost in Minnesota. However, average BP was the strongest predictor in Zutphen.

• Authors: Susanne M A J Tielemans, Johanna M Geleijnse, Alessandro Menotti, Hendriek C Boshuizen, Sabita S Soedamah-Muthu, David R Jacobs Jr, Henry Blackburn, Daan Kromhout
• Journal: Journal of the American Heart Association (J Am Heart Assoc) Vol. 4 Issue 3 Pg. e001378 (Mar 09 2015) ISSN: 2047-9980 [Electronic] England
• PMID: 25753924 (Publication Type: Comparative Study, Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
• Copyright: © 2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

Topics

• Age Factors
• Blood Pressure
• Blood Pressure Determination
• Cause of Death
• Humans
• Hypertension (diagnosis, mortality, physiopathology)
• Life Style
• Linear Models
• Male
• Middle Aged
• Minnesota (epidemiology)
• Netherlands (epidemiology)
• Occupations
• Predictive Value of Tests
• Prognosis
• Proportional Hazards Models
• Prospective Studies
• Risk Assessment
• Risk Factors
• Sex Factors
• Time Factors