Predictors of new-onset diastolic and systolic hypertension - The Framingham heart study

被引:209
作者
Franklin, SS
Pio, JR
Wong, ND
Larson, MG
Leip, EP
Vasan, RS
Levy, D
机构
[1] Univ Calif Irvine, Heart Dis Prevent Program, Irvine, CA 92697 USA
[2] Framingham Heart Dis Epidemiol Study, Framingham, MA USA
[3] NHLBI, Bethesda, MD 20892 USA
关键词
blood pressure; hypertension; aging; obesity; epidemiology;
D O I
10.1161/01.CIR.0000157159.39889.EC
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background - Factors leading differentially to the development of isolated diastolic (IDH), systolic-diastolic (SDH), and isolated systolic ( ISH) hypertension are poorly understood. We examined the relations of blood pressure ( BP) and clinical risk factors to the new onset of the 3 forms of hypertension. Methods and Results - Participants in the Framingham Heart Study were included if they had undergone 2 biennial examinations between 1953 and 1957 and were free of antihypertensive therapy and cardiovascular disease. Compared with optimal BP ( SBP < 120 and DBP < 80 mm Hg), the adjusted hazard ratios (HRs) for developing new-onset IDH over the ensuing 10 years were 2.75 for normal BP, 3.29 for high-normal BP ( both P < 0.0001), 1.31 ( P = 0.40) for SDH, and 0.61 ( P = 0.36) for ISH. The HRs of developing new-onset SDH were 3.32, 7.96, 7.10, and 23.12 for the normal BP, high-normal BP, ISH, and IDH groups, respectively ( all P < 0.0001). The HRs of developing ISH were 3.26 for normal and 4.82 for high-normal BP ( both P < 0.0001), 1.39 ( P = 0.24) for IDH, and 1.69 ( P < 0.01) for SDH. Increased body mass index (BMI) during follow-up predicted new-onset IDH and SDH. Other predictors of IDH were younger age, male sex, and BMI at baseline. Predictors of ISH included older age, female sex, and increased BMI during follow-up. Conclusion - Given the propensity for increased baseline BMI and weight gain to predict new-onset IDH and the high probability of IDH to transition to SDH, it is likely that IDH is not a benign condition. ISH arises more commonly from normal and high-normal BP than from "burned-out" diastolic hypertension.
引用
收藏
页码:1121 / 1127
页数:7
相关论文
共 24 条
[1]  
[Anonymous], 1997, ARCH INTERN MED, V157, P2413, DOI DOI 10.1001/ARCHINTE.1997.00440420033005
[2]   Overweight and hypertension - Data from the 1992-1993 Mexican Survey [J].
Arroyo, P ;
Fernandez, V ;
AvilaRosas, H .
HYPERTENSION, 1997, 30 (03) :646-649
[3]   ISOLATED ELEVATION OF DIASTOLIC BLOOD-PRESSURE - REAL OR ARTIFACTUAL [J].
BLANK, SG ;
MANN, SJ ;
JAMES, GD ;
WEST, JE ;
PICKERING, TG .
HYPERTENSION, 1995, 26 (03) :383-389
[4]  
BULPITT CJ, 1995, J HUM HYPERTENS, V9, P675
[5]   PREVALENCE OF HYPERTENSION IN THE US ADULT-POPULATION - RESULTS FROM THE 3RD NATIONAL-HEALTH AND NUTRITION EXAMINATION SURVEY, 1988-1991 [J].
BURT, VL ;
WHELTON, P ;
ROCCELLA, EJ ;
BROWN, C ;
CUTLER, JA ;
HIGGINS, M ;
HORAN, MJ ;
LABARTHE, D .
HYPERTENSION, 1995, 25 (03) :305-313
[6]   Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure [J].
Chobanian, AV ;
Bakris, GL ;
Black, HR ;
Cushman, WC ;
Green, LA ;
Izzo, JL ;
Jones, DW ;
Materson, BJ ;
Oparil, S ;
Wright, JT ;
Roccella, EJ .
HYPERTENSION, 2003, 42 (06) :1206-1252
[7]  
COX DR, 1972, J R STAT SOC B, V34, P187
[8]   AN APPROACH TO LONGITUDINAL STUDIES IN A COMMUNITY - FRAMINGHAM STUDY [J].
DAWBER, TR ;
KANNEL, WB ;
LYELL, LP .
ANNALS OF THE NEW YORK ACADEMY OF SCIENCES, 1963, 107 (02) :539-&
[9]   ISOLATED DIASTOLIC HYPERTENSION - A FAVORABLE FINDING AMONG YOUNG AND MIDDLE-AGED HYPERTENSIVE SUBJECTS [J].
FANG, J ;
MADHAVAN, S ;
COHEN, H ;
ALDERMAN, MH .
HYPERTENSION, 1995, 26 (03) :377-382
[10]   Predominance of isolated systolic hypertension among middle-aged and elderly US hypertensives - Analysis based on National Health and Nutrition Examination Survey (NHANES) III [J].
Franklin, SS ;
Jacobs, MJ ;
Wong, ND ;
L'Italien, GJ ;
Lapuerta, P .
HYPERTENSION, 2001, 37 (03) :869-874