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High blood pressure and cardiovascular disease mortality risk among U.S. adults: the third National Health and Nutrition Examination Survey mortality follow-up study.
Ann Epidemiol. 2008 Apr; 18(4):302-9.AE

Abstract

PURPOSE

We sought to examine whether prehypertension is associated with increased cardiovascular disease (CVD) mortality risk and whether the association of blood pressure with CVD outcome is modified by social demographics or hypertension treatment and control.

METHODS

Data from the Third National Health and Nutrition Examination Survey and mortality follow-up through 2000 were used to estimate the relative risk of death from CVD associated with hypertension and prehypertension, after adjusting for confounding and modifying factors.

RESULTS

Compared with normotension, the relative risks of CVD mortality were 1.23 (95% confidence interval [95% CI] 0.85-1.79, p=0.26) for prehypertension, 1.64 (95% CI 1.11-2.41, p=0.01) for hypertension, 1.74 (95% CI 1.28-2.49, p=0.007) for uncontrolled hypertension, and 1.15 (95% CI 0.79-1.80, p=0.53) for controlled hypertension. Hypertensive adults <65 years and non-Hispanic blacks had a 3.86-fold and a 4.65-fold increased CVD mortality risk respectively. Age, gender, and race/ethnicity stratified analyses showed no associations between prehypertension and CVD mortality. However, blood pressure at a high range of prehypertension (130-139/84-89 mmHg) was associated with increased risk of CVD mortality (hazard ratio 1.41, p<0.05) relative to blood pressure less than 120/80 mmHg.

CONCLUSIONS

This study supports a strong, significant, and independent association of elevated blood pressure with CVD mortality risk. Hypertension continued to greatly increase CVD morality risk, particularly among persons <65 years and non-Hispanic blacks. Treatment and control of hypertension eliminated the excess CVD mortality risk observed among the hypertension population.

Authors+Show Affiliations

Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD 20782, USA. qag3@cdc.govNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18261929

Citation

Gu, Qiuping, et al. "High Blood Pressure and Cardiovascular Disease Mortality Risk Among U.S. Adults: the Third National Health and Nutrition Examination Survey Mortality Follow-up Study." Annals of Epidemiology, vol. 18, no. 4, 2008, pp. 302-9.
Gu Q, Burt VL, Paulose-Ram R, et al. High blood pressure and cardiovascular disease mortality risk among U.S. adults: the third National Health and Nutrition Examination Survey mortality follow-up study. Ann Epidemiol. 2008;18(4):302-9.
Gu, Q., Burt, V. L., Paulose-Ram, R., Yoon, S., & Gillum, R. F. (2008). High blood pressure and cardiovascular disease mortality risk among U.S. adults: the third National Health and Nutrition Examination Survey mortality follow-up study. Annals of Epidemiology, 18(4), 302-9. https://doi.org/10.1016/j.annepidem.2007.11.013
Gu Q, et al. High Blood Pressure and Cardiovascular Disease Mortality Risk Among U.S. Adults: the Third National Health and Nutrition Examination Survey Mortality Follow-up Study. Ann Epidemiol. 2008;18(4):302-9. PubMed PMID: 18261929.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - High blood pressure and cardiovascular disease mortality risk among U.S. adults: the third National Health and Nutrition Examination Survey mortality follow-up study. AU - Gu,Qiuping, AU - Burt,Vicki L, AU - Paulose-Ram,Ryne, AU - Yoon,Sarah, AU - Gillum,Richard F, Y1 - 2008/02/08/ PY - 2007/07/03/received PY - 2007/10/26/revised PY - 2007/11/25/accepted PY - 2008/2/12/pubmed PY - 2008/7/2/medline PY - 2008/2/12/entrez SP - 302 EP - 9 JF - Annals of epidemiology JO - Ann Epidemiol VL - 18 IS - 4 N2 - PURPOSE: We sought to examine whether prehypertension is associated with increased cardiovascular disease (CVD) mortality risk and whether the association of blood pressure with CVD outcome is modified by social demographics or hypertension treatment and control. METHODS: Data from the Third National Health and Nutrition Examination Survey and mortality follow-up through 2000 were used to estimate the relative risk of death from CVD associated with hypertension and prehypertension, after adjusting for confounding and modifying factors. RESULTS: Compared with normotension, the relative risks of CVD mortality were 1.23 (95% confidence interval [95% CI] 0.85-1.79, p=0.26) for prehypertension, 1.64 (95% CI 1.11-2.41, p=0.01) for hypertension, 1.74 (95% CI 1.28-2.49, p=0.007) for uncontrolled hypertension, and 1.15 (95% CI 0.79-1.80, p=0.53) for controlled hypertension. Hypertensive adults <65 years and non-Hispanic blacks had a 3.86-fold and a 4.65-fold increased CVD mortality risk respectively. Age, gender, and race/ethnicity stratified analyses showed no associations between prehypertension and CVD mortality. However, blood pressure at a high range of prehypertension (130-139/84-89 mmHg) was associated with increased risk of CVD mortality (hazard ratio 1.41, p<0.05) relative to blood pressure less than 120/80 mmHg. CONCLUSIONS: This study supports a strong, significant, and independent association of elevated blood pressure with CVD mortality risk. Hypertension continued to greatly increase CVD morality risk, particularly among persons <65 years and non-Hispanic blacks. Treatment and control of hypertension eliminated the excess CVD mortality risk observed among the hypertension population. SN - 1047-2797 UR - https://www.unboundmedicine.com/medline/citation/18261929/High_blood_pressure_and_cardiovascular_disease_mortality_risk_among_U_S__adults:_the_third_National_Health_and_Nutrition_Examination_Survey_mortality_follow_up_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1047-2797(07)00492-9 DB - PRIME DP - Unbound Medicine ER -