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Population heterogeneity in trajectories of midlife blood pressure

Population heterogeneity in trajectories of midlife blood pressure
Population heterogeneity in trajectories of midlife blood pressure
Background: We investigated whether there are subgroups with different underlying (latent) trajectories of midlife systolic blood pressure (BP), diastolic BP, and pulse pressure in a UK cohort.

Methods: Data are from 1840 men and 1819 women with BP measured at ages 36, 43, and 53 years. We used unconditional growth mixture models to test for the presence of latent trajectory classes. Extracted classes were described in terms of a number of known lifetime risk factors, and linked to the risk of undiagnosed angina (Rose questionnaire) at age 53 years.

Results: In both sexes for systolic BP, diastolic BP, and pulse pressure, there was a large "normative" class (>90% of the sample) characterized by gentle annual increases (eg, an increase in male systolic BP of 0.9 mm Hg/year [95% confidence interval = 0.9 to 1.0]), with a smaller class for whom the rate of increase was high (eg, an increase in male systolic BP of 3.1 mm Hg/year [2.8 to 3.4]). In women, there was an additional class for whom BP was high at age 36 and remained high. Persons in the "normative" classes were, on average, heavier at birth and taller at age 7 years, had a lower midlife body mass index, and were less likely to be on antihypertensive medication compared with those in other classes. Among those with no diagnosed cardiovascular disease, those in the classes with more strongly increasing systolic BP and pulse pressure were at greatest risk of angina.

Conclusion: Our study suggests that in midlife the majority of the population have a gentle underlying increase in BP, but that there also exists an important subgroup in whom BP increases much more markedly. These classes may be useful for identifying those most at risk for cardiovascular disease.

1044-3983
203-211
Wills, A.K.
a49cf0bc-8fe1-4672-8ff2-da46760d2059
Lawlor, D.A.
666139b1-03b8-4d92-bee7-98b5913fcb31
Muniz-Terrera, G.
b1dd9234-1c31-4991-ad7a-94dbb67437af
Matthews, F.
ad769bde-7a8e-4ed5-ab1a-3275d99a4ad3
Cooper, R.
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Ghosh, A.K.
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Kuh, D.
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Hardy, R.
b3f0f66e-4cda-4e9a-aca1-955f7ecdd132
Cooper, C.
e05f5612-b493-4273-9b71-9e0ce32bdad6
Aihie Sayer, A.
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Gale, C.R.
5bb2abb3-7b53-42d6-8aa7-817e193140c8
Wills, A.K.
a49cf0bc-8fe1-4672-8ff2-da46760d2059
Lawlor, D.A.
666139b1-03b8-4d92-bee7-98b5913fcb31
Muniz-Terrera, G.
b1dd9234-1c31-4991-ad7a-94dbb67437af
Matthews, F.
ad769bde-7a8e-4ed5-ab1a-3275d99a4ad3
Cooper, R.
6cd7b578-a1fa-4511-bc7d-9addc4baf372
Ghosh, A.K.
7268e47b-3e24-45d2-b810-6862f76b68cc
Kuh, D.
6c5d95a4-433d-4895-bd95-86a7d5fe76a5
Hardy, R.
b3f0f66e-4cda-4e9a-aca1-955f7ecdd132
Cooper, C.
e05f5612-b493-4273-9b71-9e0ce32bdad6
Aihie Sayer, A.
fb4c2053-6d51-4fc1-9489-c3cb431b0ffb
Gale, C.R.
5bb2abb3-7b53-42d6-8aa7-817e193140c8

Wills, A.K., Lawlor, D.A., Muniz-Terrera, G., Matthews, F., Cooper, R., Ghosh, A.K., Kuh, D., Hardy, R., Cooper, C., Aihie Sayer, A. and Gale, C.R. (2012) Population heterogeneity in trajectories of midlife blood pressure. Epidemiology, 23 (2), 203-211. (doi:10.1097/EDE.0b013e3182456567). (PMID:22249241)

Record type: Article

Abstract

Background: We investigated whether there are subgroups with different underlying (latent) trajectories of midlife systolic blood pressure (BP), diastolic BP, and pulse pressure in a UK cohort.

Methods: Data are from 1840 men and 1819 women with BP measured at ages 36, 43, and 53 years. We used unconditional growth mixture models to test for the presence of latent trajectory classes. Extracted classes were described in terms of a number of known lifetime risk factors, and linked to the risk of undiagnosed angina (Rose questionnaire) at age 53 years.

Results: In both sexes for systolic BP, diastolic BP, and pulse pressure, there was a large "normative" class (>90% of the sample) characterized by gentle annual increases (eg, an increase in male systolic BP of 0.9 mm Hg/year [95% confidence interval = 0.9 to 1.0]), with a smaller class for whom the rate of increase was high (eg, an increase in male systolic BP of 3.1 mm Hg/year [2.8 to 3.4]). In women, there was an additional class for whom BP was high at age 36 and remained high. Persons in the "normative" classes were, on average, heavier at birth and taller at age 7 years, had a lower midlife body mass index, and were less likely to be on antihypertensive medication compared with those in other classes. Among those with no diagnosed cardiovascular disease, those in the classes with more strongly increasing systolic BP and pulse pressure were at greatest risk of angina.

Conclusion: Our study suggests that in midlife the majority of the population have a gentle underlying increase in BP, but that there also exists an important subgroup in whom BP increases much more markedly. These classes may be useful for identifying those most at risk for cardiovascular disease.

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Published date: March 2012
Organisations: Faculty of Medicine

Identifiers

Local EPrints ID: 340543
URI: http://eprints.soton.ac.uk/id/eprint/340543
ISSN: 1044-3983
PURE UUID: be8f7c17-4c1d-41c0-86fc-9e91834d120c
ORCID for C. Cooper: ORCID iD orcid.org/0000-0003-3510-0709
ORCID for C.R. Gale: ORCID iD orcid.org/0000-0002-3361-8638

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Date deposited: 25 Jun 2012 13:54
Last modified: 18 Feb 2021 16:48

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Contributors

Author: A.K. Wills
Author: D.A. Lawlor
Author: G. Muniz-Terrera
Author: F. Matthews
Author: R. Cooper
Author: A.K. Ghosh
Author: D. Kuh
Author: R. Hardy
Author: C. Cooper ORCID iD
Author: A. Aihie Sayer
Author: C.R. Gale ORCID iD

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