Blood pressure and cardiovascular disease

Blood pressure a strong predictor of CVD mortality

Systolic blood pressure in middle-aged men was an important predictor of 10-, 25-, 35- and 40-year CHD mortality in all cohorts. The 35-year follow-up data showed that past blood pressure levels are more important than recent values. Systolic blood pressure was also strongly associated with 25-, 35- and 40-year stroke mortality. Both recent and past blood pressure level were strongly predictive of stroke. The Zutphen Study found that the strength of the relation between blood pressure and 15-year stroke incidence doubled when 11 repeated casual pressures were measured. Blood pressure was also strongly related to 40-year total CVD mortality in the US railroad cohort.

Population differences in absolute CHD risk

Systolic blood pressure and 25-year CHD mortality

The results after 10 and 25 years of follow-up showed that the relative risks from blood pressure level are similar across cohorts, while at the same level of blood pressure the absolute risks of CHD mortality are different. High absolute risk was present in Northern Europe and the United States and low risk in Mediterranean Southern Europe and Japan.
Implication

Relative risk of CHD associated with blood pressure is similar but absolute risk differs among the cohorts. This implies that elevated blood pressure levels need to be treated more intensely in high risk cultures to achieve target levels and potential prevention.

References

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