Journal
HYPERTENSION RESEARCH
Volume 35, Issue 9, Pages 947-953Publisher
SPRINGERNATURE
DOI: 10.1038/hr.2012.87
Keywords
blood pressure category; cardiovascular death; cohort; elderly; population attributable fraction
Categories
Funding
- Ministry of Health, Labour and Welfare, Health and Labor Sciences research grants, Japan (Research on Health Services) [H17-Kenkou-007]
- Ministry of Health, Labour and Welfare, Health and Labor Sciences research grants, Japan (Comprehensive Research on Cardiovascular Disease and Life-Related Disease) [H18-Junkankitou[Seishuu]-Ippan-012, H19-Junkankitou [Seishuu]-Ippan-012]
- Ministry of Health, Labour and Welfare, Health and Labor Sciences research grants, Japan (Comprehensive Research on Cardiovascular and Life-Style Related Diseases) [H20-Junkankitou [Seishuu]-Ippan-013, H23-Junkankitou [Seishuu]-Ippan-005]
- Grants-in-Aid for Scientific Research [23249036] Funding Source: KAKEN
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Blood pressure (BP) categories defined by systolic BP (SBP) and diastolic BP (DBP) are commonly used. However, the BP category-specific risk of cardiovascular disease (CVD) has not been thoroughly investigated in different age groups. The aim of this study was to assess long-term CVD risk and its impact according to BP categories and age group. Pooling individual data from 10 cohorts, we studied 67 309 Japanese individuals (40-89 years old) who were free of CVD at baseline: we categorized them as belonging to three age groups: 'middle-aged' (40-64 years), 'elderly' (65-74 years) and 'very elderly' (75-89 years). BP was classified according to the 2009 Japanese Society of Hypertension Guidelines. Cox models were used to estimate adjusted hazard ratios for CVD deaths. We observed 1944 CVD deaths over a mean follow-up of 10.2 years. In all age groups, the overall relationship between BP category and CVD risk was positive, with a greater strength observed for younger age groups. We observed a trend of increased risk from SBP/DBP >= 130/85 mm Hg in the very elderly, and a significant increase from SBP/DBP >= 120/80 mm Hg in the other age groups. The population attributable fractions (PAFs) of CVD death in reference to the SBP/DBP < 120/80 mm Hg category ranged from 23.4% in the very elderly to 60.3% in the middle-aged. We found an overall graded increase in CVD risk with higher BP category in the very elderly. The PAFs suggest that keeping BP levels low is an important strategy for primary CVD prevention, even in an elderly population. Hypertension Research (2012) 35, 947-953; doi:10.1038/hr.2012.87; published online 28 June 2012
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