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Relative and Absolute Risk to Guide the Management of Pulse Pressure, an Age-Related Cardiovascular Risk Factor

Melgarejo, Jesus D. (författare)
Univ Leuven, KU Leuven Dept Cardiovasc Sci, Res Unit Hypertens & Cardiovasc Epidemiol, Leuven, Belgium.;Univ Zulia, Fac Med, Lab Neurosci, Maracaibo, Zulia, Venezuela.
Thijs, Lutgarde (författare)
Univ Leuven, KU Leuven Dept Cardiovasc Sci, Res Unit Hypertens & Cardiovasc Epidemiol, Leuven, Belgium.
Wei, Dong-Mei (författare)
Univ Leuven, KU Leuven Dept Cardiovasc Sci, Res Unit Hypertens & Cardiovasc Epidemiol, Leuven, Belgium.
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Bursztyn, Michael (författare)
Hadassah Hebrew Univ, Hebrew Univ, Fac Med, Dept Internal Med,Med Ctr, Jerusalem, Israel.
Yang, Wen-Yi (författare)
Shanghai Jiao Tong Univ, Shanghai Gen Hosp, Dept Cardiol, Sch Med, Shanghai, Peoples R China.
Li, Yan (författare)
Shanghai Jiao Tong Univ, Ruijin Hosp, Ctr Epidemiol Studies & Clin Trials, Sch Med, Shanghai, Peoples R China.;Shanghai Jiao Tong Univ, Ruijin Hosp, Sch Med, Ctr Vasc Evaluat,Shanghai Inst Hypertens,Shanghai, Shanghai, Peoples R China.
Asayama, Kei (författare)
Teikyo Univ, Dept Hyg & Publ Hlth, Sch Med, Tokyo, Japan.;Tohoku Inst Management Blood Pressure, Sendai, Miyagi, Japan.
Hansen, Tine W. (författare)
Steno Diabet Ctr Copenhagen, Gentofte, Denmark.;Bispebjerg & Frederiksberg Hosp, Ctr Clin Res & Prevent, Frederiksberg, Denmark.
Kikuya, Masahiro (författare)
Teikyo Univ, Dept Hyg & Publ Hlth, Sch Med, Tokyo, Japan.
Ohkubo, Takayoshi (författare)
Teikyo Univ, Dept Hyg & Publ Hlth, Sch Med, Tokyo, Japan.;Tohoku Inst Management Blood Pressure, Sendai, Miyagi, Japan.
Dolan, Eamon (författare)
Stroke & Hypertens Unit, Dublin, Ireland.
Stolarz-Skrzypek, Katarzyna (författare)
Jagiellonian Univ Med Coll, Dept Cardiol Intervent Electrocardiol & Hypertens, Krakow, Poland.
Cheng, Yi-Bang (författare)
Shanghai Jiao Tong Univ, Ruijin Hosp, Ctr Epidemiol Studies & Clin Trials, Sch Med, Shanghai, Peoples R China.;Shanghai Jiao Tong Univ, Ruijin Hosp, Sch Med, Ctr Vasc Evaluat,Shanghai Inst Hypertens,Shanghai, Shanghai, Peoples R China.
Tikhonoff, Valerie (författare)
Univ Padua, Dept Med, Padua, Italy.
Malyutina, Sofia (författare)
Russian Acad Sci, Inst Internal & Prevent Med, Internal & Prevent Med Branch, Inst Cytol & Genet,Siberian Branch, Novosibirsk, Russia.
Casiglia, Edoardo (författare)
Univ Padua, Dept Med, Padua, Italy.
Lind, Lars (författare)
Uppsala universitet,Geriatrik
Sandoya, Edgardo (författare)
Asociac Espanola Primera Socorros Mutuos, Montevideo, Uruguay.
Filipovsky, Jan (författare)
Charles Univ Prague, Fac Med, Plzen, Czech Republic.
Narkiewicz, Krzysztof (författare)
Med Univ Gdansk, Dept Hypertens, Gdansk, Poland.
Gilis-Malinowska, Natasza (författare)
Med Univ Gdansk, Dept Hypertens, Gdansk, Poland.
Kawecka-Jaszcz, Kalina (författare)
Jagiellonian Univ Med Coll, Dept Cardiol Intervent Electrocardiol & Hypertens, Krakow, Poland.
Boggia, Jose (författare)
Univ Republica, Hosp Clin, Ctr Nefrol, Montevideo, Uruguay.;Univ Republica, Hosp Clin, Dept Fisiopatol, Montevideo, Uruguay.
Wang, Ji-Guang (författare)
Shanghai Jiao Tong Univ, Ruijin Hosp, Ctr Epidemiol Studies & Clin Trials, Sch Med, Shanghai, Peoples R China.;Shanghai Jiao Tong Univ, Ruijin Hosp, Sch Med, Ctr Vasc Evaluat,Shanghai Inst Hypertens,Shanghai, Shanghai, Peoples R China.
Imai, Yutaka (författare)
Tohoku Inst Management Blood Pressure, Sendai, Miyagi, Japan.
Verhamme, Peter (författare)
Univ Leuven, Ctr Mol & Vasc Biol, KU Leuven Dept Cardiovasc Sci, Leuven, Belgium.
Trenson, Sander (författare)
Univ Hosp Leuven, Dept Internal Med, Div Cardiol, Leuven, Belgium.
Janssens, Stefan (författare)
Univ Hosp Leuven, Dept Internal Med, Div Cardiol, Leuven, Belgium.
O'Brien, Eoin (författare)
Univ Coll Dublin, Conway Inst, Dublin, Ireland.
Maestre, Gladys E. (författare)
Univ Zulia, Fac Med, Lab Neurosci, Maracaibo, Zulia, Venezuela.;Univ Texas Rio Grande Valley, Dept Neurosci, Sch Med, Brownsville, TX USA.;Univ Texas Rio Grande Valley, Dept Human Genet, Sch Med, Brownsville, TX USA.;Univ Texas Rio Grande Valley, Alzheimers Dis Resource Ctr Minor Aging Res, Brownsville, TX USA.
Gavish, Benjamin (författare)
Yazmonit Ltd, Jerusalem, Israel.
Staessen, Jan A. (författare)
Res Inst Alliance Promot Prevent Med, Mechelen, Belgium.;Univ Leuven, Fac Med, Biomed Sci Grp, Leuven, Belgium.
Zhang, Zhen-Yu (författare)
Univ Leuven, KU Leuven Dept Cardiovasc Sci, Res Unit Hypertens & Cardiovasc Epidemiol, Leuven, Belgium.
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Univ Leuven, KU Leuven Dept Cardiovasc Sci, Res Unit Hypertens & Cardiovasc Epidemiol, Leuven, Belgium;Univ Zulia, Fac Med, Lab Neurosci, Maracaibo, Zulia, Venezuela. Univ Leuven, KU Leuven Dept Cardiovasc Sci, Res Unit Hypertens & Cardiovasc Epidemiol, Leuven, Belgium. (creator_code:org_t)
2021-03-04
2021
Engelska.
Ingår i: American Journal of Hypertension. - : Oxford University Press. - 0895-7061 .- 1941-7225. ; 34:9, s. 929-938
Relaterad länk:
https://doi.org/10.1...
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https://uu.diva-port... (primary) (Raw object)
https://academic.oup...
https://urn.kb.se/re...
https://doi.org/10.1...
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  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
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  • BACKGROUND Pulse pressure (PP) reflects the age-related stiffening of the central arteries, but no study addressed the management of the PP-related risk over the human lifespan.METHODS In 4,663 young (18-49 years) and 7,185 older adults (>= 50 years), brachial PP was recorded over 24 hours. Total mortality and all major cardiovascular events (MACEs) combined were coprimary endpoints. Cardiovascular death, coronary events, and stroke were secondary endpoints.RESULTS In young adults (median follow-up, 14.1 years; mean PP, 45.1 mm Hg), greater PP was not associated with absolute risk; the endpoint rates were <= 2.01 per 1,000 person-years. The adjusted hazard ratios expressed per 10-mm Hg PP increments were less than unity (P <= 0.027) for MACE (0.67; 95% confidence interval [CI], 0.47-0.96) and cardiovascular death (0.33; 95% CI, 0.11-0.75). In older adults (median follow-up, 13.1 years; mean PP, 52.7 mm Hg), the endpoint rates, expressing absolute risk, ranged from 22.5 to 45.4 per 1,000 person-years and the adjusted hazard ratios, reflecting relative risk, from 1.09 to 1.54 (P < 0.0001). The PP-related relative risks of death, MACE, and stroke decreased >3-fold from age 55 to 75 years, whereas absolute risk rose by a factor 3.CONCLUSIONS From 50 years onwards, the PP-related relative risk decreases, whereas absolute risk increases. From a lifecourse perspective, young adulthood provides a window of opportunity to manage risk factors and prevent target organ damage as forerunner of premature death and MACE. In older adults, treatment should address absolute risk, thereby extending life in years and quality.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kardiologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)

Nyckelord

arterial stiffness
blood pressure
cardiovascular disease
pulse pressure
hypertension
mortality
population science

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