Do other cardiovascular risk factors influence the impact of age on the association between blood pressure and mortality?

The MORGAM Project

Julie K K Vishram, Anders Borglykke, Anne H Andreasen, Jørgen Jeppesen, Hans Ibsen, Torben Jørgensen, Grazyna Broda, Luigi Palmieri, Simona Giampaoli, Chiara Donfrancesco, Frank Kee, Giuseppe Mancia, Giancarlo Cesana, Kari Kuulasmaa, Veikko Salomaa, Susana Sans, Jean Ferrieres, Abdonas Tamosiunas, Stefan Söderberg, Patrick McElduff & 4 andre Dominique Arveiler, Andrzej Pajak, Michael H Olsen, MORGAM Project

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

OBJECTIVE: To investigate age-related shifts in the relative importance of SBP and DBP as predictors of cardiovascular mortality and all-cause mortality and whether these relations are influenced by other cardiovascular risk factors.

METHODS: Using 42 cohorts from the MORGAM Project with baseline between 1982 and 1997, 85 772 apparently healthy Europeans and Australians aged 19-78 years were included. During 13.3 years of follow-up, 9.2% died (of whom 7.2% died due to stroke and 21.1% due to coronary heart disease, CHD).

RESULTS: Mortality risk was analyzed using hazard ratios per 10-mmHg/5-mmHg increase in SBP/DBP by multivariate-adjusted Cox regressions, including SBP and DBP simultaneously. Because of nonlinearity, SBP and DBP were analyzed separately for blood pressure (BP) values above and below a cut-point wherein mortality risk was the lowest. For the total population, significantly positive associations were found between stroke mortality and SBP [hazard ratio = 1.19 (1.13-1.25)] and DBP at least 78 mmHg [hazard ratio = 1.08 (1.02-1.14)], CHD mortality and SBP at least 116 mmHg [1.20 (1.16-1.24)], and all-cause mortality and SBP at least 120 mmHg [1.09 (1.08-1.11)] and DBP at least 82 mmHg [1.03 (1.02-1.05)]. BP values below the cut-points were inversely related to mortality risk. Taking into account the age × BP interaction, there was a gradual shift from DBP (19-26 years) to both DBP and SBP (27-62 years) and to SBP (63-78 years) as risk factors for stroke mortality and all-cause mortality, but not CHD mortality. The age at which the importance of SBP exceeded DBP was for stroke mortality influenced by sex, cholesterol, and country risk.

CONCLUSION: Age-related shifts to the superiority of SBP exist for stroke mortality and all-cause mortality, and for stroke mortality was this shift influenced by other cardiovascular risk factors.

OriginalsprogEngelsk
TidsskriftHypertension
Vol/bind32
Udgave nummer5
Sider (fra-til)1025-32
ISSN0194-911X
DOI
StatusUdgivet - maj 2014

Fingeraftryk

Population

Citer dette

Vishram, J. K. K., Borglykke, A., Andreasen, A. H., Jeppesen, J., Ibsen, H., Jørgensen, T., ... MORGAM Project (2014). Do other cardiovascular risk factors influence the impact of age on the association between blood pressure and mortality? The MORGAM Project. Hypertension, 32(5), 1025-32. https://doi.org/10.1097/HJH.0000000000000133
Vishram, Julie K K ; Borglykke, Anders ; Andreasen, Anne H ; Jeppesen, Jørgen ; Ibsen, Hans ; Jørgensen, Torben ; Broda, Grazyna ; Palmieri, Luigi ; Giampaoli, Simona ; Donfrancesco, Chiara ; Kee, Frank ; Mancia, Giuseppe ; Cesana, Giancarlo ; Kuulasmaa, Kari ; Salomaa, Veikko ; Sans, Susana ; Ferrieres, Jean ; Tamosiunas, Abdonas ; Söderberg, Stefan ; McElduff, Patrick ; Arveiler, Dominique ; Pajak, Andrzej ; Olsen, Michael H ; MORGAM Project. / Do other cardiovascular risk factors influence the impact of age on the association between blood pressure and mortality? The MORGAM Project. I: Hypertension. 2014 ; Bind 32, Nr. 5. s. 1025-32.
@article{b4e0ccf99f9c4025a01b91c35a9a970d,
title = "Do other cardiovascular risk factors influence the impact of age on the association between blood pressure and mortality?: The MORGAM Project",
abstract = "OBJECTIVE: To investigate age-related shifts in the relative importance of SBP and DBP as predictors of cardiovascular mortality and all-cause mortality and whether these relations are influenced by other cardiovascular risk factors.METHODS: Using 42 cohorts from the MORGAM Project with baseline between 1982 and 1997, 85 772 apparently healthy Europeans and Australians aged 19-78 years were included. During 13.3 years of follow-up, 9.2{\%} died (of whom 7.2{\%} died due to stroke and 21.1{\%} due to coronary heart disease, CHD).RESULTS: Mortality risk was analyzed using hazard ratios per 10-mmHg/5-mmHg increase in SBP/DBP by multivariate-adjusted Cox regressions, including SBP and DBP simultaneously. Because of nonlinearity, SBP and DBP were analyzed separately for blood pressure (BP) values above and below a cut-point wherein mortality risk was the lowest. For the total population, significantly positive associations were found between stroke mortality and SBP [hazard ratio = 1.19 (1.13-1.25)] and DBP at least 78 mmHg [hazard ratio = 1.08 (1.02-1.14)], CHD mortality and SBP at least 116 mmHg [1.20 (1.16-1.24)], and all-cause mortality and SBP at least 120 mmHg [1.09 (1.08-1.11)] and DBP at least 82 mmHg [1.03 (1.02-1.05)]. BP values below the cut-points were inversely related to mortality risk. Taking into account the age × BP interaction, there was a gradual shift from DBP (19-26 years) to both DBP and SBP (27-62 years) and to SBP (63-78 years) as risk factors for stroke mortality and all-cause mortality, but not CHD mortality. The age at which the importance of SBP exceeded DBP was for stroke mortality influenced by sex, cholesterol, and country risk.CONCLUSION: Age-related shifts to the superiority of SBP exist for stroke mortality and all-cause mortality, and for stroke mortality was this shift influenced by other cardiovascular risk factors.",
keywords = "Adult, Age Factors, Aged, Blood Pressure, Cardiovascular Diseases, Cohort Studies, Humans, Middle Aged, Risk Factors, Young Adult",
author = "Vishram, {Julie K K} and Anders Borglykke and Andreasen, {Anne H} and J{\o}rgen Jeppesen and Hans Ibsen and Torben J{\o}rgensen and Grazyna Broda and Luigi Palmieri and Simona Giampaoli and Chiara Donfrancesco and Frank Kee and Giuseppe Mancia and Giancarlo Cesana and Kari Kuulasmaa and Veikko Salomaa and Susana Sans and Jean Ferrieres and Abdonas Tamosiunas and Stefan S{\"o}derberg and Patrick McElduff and Dominique Arveiler and Andrzej Pajak and Olsen, {Michael H} and {MORGAM Project}",
year = "2014",
month = "5",
doi = "10.1097/HJH.0000000000000133",
language = "English",
volume = "32",
pages = "1025--32",
journal = "Hypertension",
issn = "0194-911X",
publisher = "Lippincott Williams & Wilkins",
number = "5",

}

Vishram, JKK, Borglykke, A, Andreasen, AH, Jeppesen, J, Ibsen, H, Jørgensen, T, Broda, G, Palmieri, L, Giampaoli, S, Donfrancesco, C, Kee, F, Mancia, G, Cesana, G, Kuulasmaa, K, Salomaa, V, Sans, S, Ferrieres, J, Tamosiunas, A, Söderberg, S, McElduff, P, Arveiler, D, Pajak, A, Olsen, MH & MORGAM Project 2014, 'Do other cardiovascular risk factors influence the impact of age on the association between blood pressure and mortality? The MORGAM Project', Hypertension, bind 32, nr. 5, s. 1025-32. https://doi.org/10.1097/HJH.0000000000000133

Do other cardiovascular risk factors influence the impact of age on the association between blood pressure and mortality? The MORGAM Project. / Vishram, Julie K K; Borglykke, Anders; Andreasen, Anne H; Jeppesen, Jørgen; Ibsen, Hans; Jørgensen, Torben; Broda, Grazyna; Palmieri, Luigi; Giampaoli, Simona; Donfrancesco, Chiara; Kee, Frank; Mancia, Giuseppe; Cesana, Giancarlo; Kuulasmaa, Kari; Salomaa, Veikko; Sans, Susana; Ferrieres, Jean; Tamosiunas, Abdonas; Söderberg, Stefan; McElduff, Patrick; Arveiler, Dominique; Pajak, Andrzej; Olsen, Michael H; MORGAM Project.

I: Hypertension, Bind 32, Nr. 5, 05.2014, s. 1025-32.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Do other cardiovascular risk factors influence the impact of age on the association between blood pressure and mortality?

T2 - The MORGAM Project

AU - Vishram, Julie K K

AU - Borglykke, Anders

AU - Andreasen, Anne H

AU - Jeppesen, Jørgen

AU - Ibsen, Hans

AU - Jørgensen, Torben

AU - Broda, Grazyna

AU - Palmieri, Luigi

AU - Giampaoli, Simona

AU - Donfrancesco, Chiara

AU - Kee, Frank

AU - Mancia, Giuseppe

AU - Cesana, Giancarlo

AU - Kuulasmaa, Kari

AU - Salomaa, Veikko

AU - Sans, Susana

AU - Ferrieres, Jean

AU - Tamosiunas, Abdonas

AU - Söderberg, Stefan

AU - McElduff, Patrick

AU - Arveiler, Dominique

AU - Pajak, Andrzej

AU - Olsen, Michael H

AU - MORGAM Project

PY - 2014/5

Y1 - 2014/5

N2 - OBJECTIVE: To investigate age-related shifts in the relative importance of SBP and DBP as predictors of cardiovascular mortality and all-cause mortality and whether these relations are influenced by other cardiovascular risk factors.METHODS: Using 42 cohorts from the MORGAM Project with baseline between 1982 and 1997, 85 772 apparently healthy Europeans and Australians aged 19-78 years were included. During 13.3 years of follow-up, 9.2% died (of whom 7.2% died due to stroke and 21.1% due to coronary heart disease, CHD).RESULTS: Mortality risk was analyzed using hazard ratios per 10-mmHg/5-mmHg increase in SBP/DBP by multivariate-adjusted Cox regressions, including SBP and DBP simultaneously. Because of nonlinearity, SBP and DBP were analyzed separately for blood pressure (BP) values above and below a cut-point wherein mortality risk was the lowest. For the total population, significantly positive associations were found between stroke mortality and SBP [hazard ratio = 1.19 (1.13-1.25)] and DBP at least 78 mmHg [hazard ratio = 1.08 (1.02-1.14)], CHD mortality and SBP at least 116 mmHg [1.20 (1.16-1.24)], and all-cause mortality and SBP at least 120 mmHg [1.09 (1.08-1.11)] and DBP at least 82 mmHg [1.03 (1.02-1.05)]. BP values below the cut-points were inversely related to mortality risk. Taking into account the age × BP interaction, there was a gradual shift from DBP (19-26 years) to both DBP and SBP (27-62 years) and to SBP (63-78 years) as risk factors for stroke mortality and all-cause mortality, but not CHD mortality. The age at which the importance of SBP exceeded DBP was for stroke mortality influenced by sex, cholesterol, and country risk.CONCLUSION: Age-related shifts to the superiority of SBP exist for stroke mortality and all-cause mortality, and for stroke mortality was this shift influenced by other cardiovascular risk factors.

AB - OBJECTIVE: To investigate age-related shifts in the relative importance of SBP and DBP as predictors of cardiovascular mortality and all-cause mortality and whether these relations are influenced by other cardiovascular risk factors.METHODS: Using 42 cohorts from the MORGAM Project with baseline between 1982 and 1997, 85 772 apparently healthy Europeans and Australians aged 19-78 years were included. During 13.3 years of follow-up, 9.2% died (of whom 7.2% died due to stroke and 21.1% due to coronary heart disease, CHD).RESULTS: Mortality risk was analyzed using hazard ratios per 10-mmHg/5-mmHg increase in SBP/DBP by multivariate-adjusted Cox regressions, including SBP and DBP simultaneously. Because of nonlinearity, SBP and DBP were analyzed separately for blood pressure (BP) values above and below a cut-point wherein mortality risk was the lowest. For the total population, significantly positive associations were found between stroke mortality and SBP [hazard ratio = 1.19 (1.13-1.25)] and DBP at least 78 mmHg [hazard ratio = 1.08 (1.02-1.14)], CHD mortality and SBP at least 116 mmHg [1.20 (1.16-1.24)], and all-cause mortality and SBP at least 120 mmHg [1.09 (1.08-1.11)] and DBP at least 82 mmHg [1.03 (1.02-1.05)]. BP values below the cut-points were inversely related to mortality risk. Taking into account the age × BP interaction, there was a gradual shift from DBP (19-26 years) to both DBP and SBP (27-62 years) and to SBP (63-78 years) as risk factors for stroke mortality and all-cause mortality, but not CHD mortality. The age at which the importance of SBP exceeded DBP was for stroke mortality influenced by sex, cholesterol, and country risk.CONCLUSION: Age-related shifts to the superiority of SBP exist for stroke mortality and all-cause mortality, and for stroke mortality was this shift influenced by other cardiovascular risk factors.

KW - Adult

KW - Age Factors

KW - Aged

KW - Blood Pressure

KW - Cardiovascular Diseases

KW - Cohort Studies

KW - Humans

KW - Middle Aged

KW - Risk Factors

KW - Young Adult

U2 - 10.1097/HJH.0000000000000133

DO - 10.1097/HJH.0000000000000133

M3 - Journal article

VL - 32

SP - 1025

EP - 1032

JO - Hypertension

JF - Hypertension

SN - 0194-911X

IS - 5

ER -