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Titolo:
Association between blood pressure level and the risk of myocardial infarction, stroke, and total mortality - The cardiovascular health study
Autore:
Psaty, BM; Furberg, CD; Kuller, LH; Cushman, M; Savage, P; Levine, D; OLeary, DH; Bryan, RN; Anderson, M; Lumley, T;
Indirizzi:
Univ Washington, Dept Med, Cardiovasc Hlth Res Unit, Seattle, WA 98195 USAUniv Washington Seattle WA USA 98195 Hlth Res Unit, Seattle, WA 98195 USA Univ Washington, Dept Epidemiol & Hlth Serv, Seattle, WA 98195 USA Univ Washington Seattle WA USA 98195 l & Hlth Serv, Seattle, WA 98195 USA Wake Forest Univ, Sch Med, Dept Publ Hlth Sci, Winston Salem, NC 27109 USAWake Forest Univ Winston Salem NC USA 27109 , Winston Salem, NC 27109 USA Univ Pittsburgh, Dept Epidemiol, Pittsburgh, PA 15261 USA Univ PittsburghPittsburgh PA USA 15261 idemiol, Pittsburgh, PA 15261 USA Univ Vermont, Dept Med, Colchester, VT USA Univ Vermont Colchester VT USA niv Vermont, Dept Med, Colchester, VT USA Univ Vermont, Dept Pathol, Colchester, VT USA Univ Vermont Colchester VT USA Vermont, Dept Pathol, Colchester, VT USA NHLBI, Div Epidemiol & Clin Applicat, Epidemiol & Biometry Program, Bethesda, MD 20892 USA NHLBI Bethesda MD USA 20892 ol & Biometry Program, Bethesda, MD 20892 USA Johns Hopkins Univ, Dept Med, Baltimore, MD USA Johns Hopkins Univ Baltimore MD USA ns Univ, Dept Med, Baltimore, MD USA Tufts Univ, New England Med Ctr, Dept Radiol, Boston, MA 02111 USA Tufts Univ Boston MA USA 02111 Med Ctr, Dept Radiol, Boston, MA 02111 USA Univ Penn, Dept Radiol, Philadelphia, PA 19104 USA Univ Penn PhiladelphiaPA USA 19104 pt Radiol, Philadelphia, PA 19104 USA Univ Washington, Dept Biostat, Seattle, WA 98195 USA Univ Washington Seattle WA USA 98195 Dept Biostat, Seattle, WA 98195 USA Wake Forest Univ, Electrocardiog Reading Ctr, Winston Salem, NC 27109 USA Wake Forest Univ Winston Salem NC USA 27109 , Winston Salem, NC 27109 USA Univ Calif Davis, Davis, CA 95616 USA Univ Calif Davis Davis CA USA 95616Univ Calif Davis, Davis, CA 95616 USA Johns Hopkins Univ, MRI Reading Ctr, Baltimore, MD 21205 USA Johns HopkinsUniv Baltimore MD USA 21205 ng Ctr, Baltimore, MD 21205 USA Univ Calif Irvine, Echocardiog Reading Ctr Baseline, Irvine, CA 92697 USA Univ Calif Irvine Irvine CA USA 92697 Ctr Baseline, Irvine, CA 92697 USA Georgetown Med Ctr, Echocardiog Reading Ctr, Washington, DC USA GeorgetownMed Ctr Washington DC USA iog Reading Ctr, Washington, DC USA New England Med Ctr, Ultrasound Reading Ctr, Boston, MA 02111 USA New England Med Ctr Boston MA USA 02111 Reading Ctr, Boston, MA 02111 USA Univ Vermont, Cent Blood Anal Lab, Colchester, VT USA Univ Vermont Colchester VT USA , Cent Blood Anal Lab, Colchester, VT USA Univ Arizona, Pulmonary Reading Ctr, Tucson, AZ 85721 USA Univ Arizona Tucson AZ USA 85721 monary Reading Ctr, Tucson, AZ 85721 USA Univ Washington, Coordinating Ctr, Seattle, WA 98195 USA Univ Washington Seattle WA USA 98195 rdinating Ctr, Seattle, WA 98195 USA NHLBI, Project Off, Bethesda, MD 20892 USA NHLBI Bethesda MD USA 20892NHLBI, Project Off, Bethesda, MD 20892 USA
Titolo Testata:
ARCHIVES OF INTERNAL MEDICINE
fascicolo: 9, volume: 161, anno: 2001,
pagine: 1183 - 1192
SICI:
0003-9926(20010514)161:9<1183:ABBPLA>2.0.ZU;2-H
Fonte:
ISI
Lingua:
ENG
Soggetto:
ISOLATED SYSTOLIC HYPERTENSION; CORONARY HEART-DISEASE; PULSE PRESSURE; OLDER ADULTS; METAANALYSIS; OUTCOMES;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
37
Recensione:
Indirizzi per estratti:
Indirizzo: Psaty, BM Coordinat Ctr, Cardiovasc Hlth Study, Plaza 600,Bldg 600,StewartSt,Suite 700, Seattle, WA 98101 USA Coordinat Ctr Plaza 600,Bldg 600,Stewart St,Suite 700 Seattle WA USA 98101
Citazione:
B.M. Psaty et al., "Association between blood pressure level and the risk of myocardial infarction, stroke, and total mortality - The cardiovascular health study", ARCH IN MED, 161(9), 2001, pp. 1183-1192

Abstract

Background: Recent reports have drawn attention to the importance of pulsepressure as a predictor of cardiovascular events. Pulse pressure is used neither by clinicians nor by guidelines to define treatable levels of blood pressure. Methods: In the Cardiovascular Health Study, 5888 adults 65 years and older were recruited from 4 US centers. At baseline in 1989-1990, participants underwent an extensive examination, and all subsequent cardiovascular events were ascertained and classified. Results: At baseline, 1961 men and 2941 women were at risk for an incidentmyocardial infarction or stroke. During follow-up that averaged 6.7 years,572 subjects had a coronary event, 385 had a stroke, and 896 died. After adjustment for potential confounders, systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse pressure were directly associated with the risk of incident myocardial infarction and stroke. Only SEP was associated with total mortality. Importantly, SEP was a better predictor of cardiovascular events than DBP or pulse pressure. In the adjusted model for myocardial infarction, a 1-SD change in SEP, DBP, and pulse pressure was associated with hazard ratios (95% confidence intervals) of 1.24 (1.15-1.35), 1.13 (1.04-1.22), and 1.21 (1.12-1.31), respectively; and adding pulse pressure or DBP to the model did not improve the fit. For stroke, the hazard ratios (95% confidence intervals) were 1.34 (1.21-1.47) with SEP, 1.29 (1.17-1.42)with DBP, and 1.21 (1.10-1.34) with pulse pressure. The association between blood pressure level and cardiovascular disease risk was generally linear; specifically, there was no evidence of a J-shaped relationship. In those with treated hypertension, the hazard ratios for the association of SEP with the risks for myocardial infarction and stroke were less pronounced than in those without treated hypertension. Conclusion: In this population-based study of older adults, although all measures of blood pressure were strongly and. directly related to the risk of coronary and cerebrovascular events, SEP was the best single predictor ofcardiovascular events.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 28/11/20 alle ore 21:37:37