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Single Versus Combined Blood Pressure Components and Risk for Cardiovascular Disease : The Framingham Heart Study

Circulation (New York, N.Y.), 2009-01, Vol.119 (2), p.243-250 [Peer Reviewed Journal]

2009 INIST-CNRS ;ISSN: 0009-7322 ;EISSN: 1524-4539 ;DOI: 10.1161/CIRCULATIONAHA.108.797936 ;PMID: 19118251 ;CODEN: CIRCAZ

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Title:
Single Versus Combined Blood Pressure Components and Risk for Cardiovascular Disease : The Framingham Heart Study
Author: FRANKLIN, Stanley S ; LOPEZ, Victor A ; WONG, Nathan D ; MITCHELL, Gary F ; LARSON, Martin G ; VASAN, Ramachandran S ; LEVY, Daniel
Subjects: Adult ; Biological and medical sciences ; Blood and lymphatic vessels ; Blood Pressure - physiology ; Blood Pressure Determination - methods ; Cardiology. Vascular system ; Cardiovascular Diseases - diagnosis ; Cardiovascular Diseases - physiopathology ; Cardiovascular Diseases - prevention & control ; Cohort Studies ; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous ; Female ; Humans ; Longitudinal Studies ; Male ; Medical sciences ; Middle Aged ; Neuropharmacology ; Pharmacology. Drug treatments ; Predictive Value of Tests ; Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer ; Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer..., (alzheimer disease) ; Psychology. Psychoanalysis. Psychiatry ; Psychopharmacology ; Risk Factors
Is Part Of: Circulation (New York, N.Y.), 2009-01, Vol.119 (2), p.243-250
Description: The utility of single versus combined blood pressure (BP) components in predicting cardiovascular disease (CVD) events is not established. We compared systolic BP (SBP) and diastolic BP (DBP) versus pulse pressure (PP) and mean arterial pressure (MAP) combined and each of these 4 BP components alone in predicting CVD events. In participants in the original (n=4760) and offspring (n=4897) Framingham Heart Study who were free of CVD events and BP-lowering therapy, 1439 CVD events occurred over serial 4-year intervals from 1952 to 2001. In pooled logistic regression with the use of BP categories, combining SBP with DBP and PP with MAP improved model fit compared with individual BP components (P<0.05 to P<0.0001). Significant interactions were noted between SBP and DBP (P=0.02) and between PP and MAP (P=0.01) in their respective multivariable models. Models with continuous variables for SBP+DBP and PP+MAP proved identical in predicting CVD events (Akaike Information Criteria=10 625 for both). Addition of a quadratic DBP(2) term to DBP and SBP further improved fit (P=0.0016). Combining PP with MAP and SBP with DBP produced models that were superior to single BP components for predicting CVD, and the extent of CVD risk varied with the level of each BP component. The combination of PP+MAP (unlike SBP+DBP) has a monotonic relation with risk and may provide greater insight into hemodynamics of altered arterial stiffness versus impaired peripheral resistance but is not superior to SBP+DBP in predicting CVD events.
Publisher: Hagerstown, MD: Lippincott Williams & Wilkins
Language: English
Identifier: ISSN: 0009-7322
EISSN: 1524-4539
DOI: 10.1161/CIRCULATIONAHA.108.797936
PMID: 19118251
CODEN: CIRCAZ
Source: Geneva Foundation Free Medical Journals at publisher websites
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Single Versus Combined Blood Pressure Components and Risk for Cardiovascular Disease : The Framingham Heart Study

2009 INIST-CNRS ;ISSN: 0009-7322 ;EISSN: 1524-4539 ;DOI: 10.1161/CIRCULATIONAHA.108.797936 ;PMID: 19118251 ;CODEN: CIRCAZ

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