Determinants of Isolated Systolic Hypertension FREE

Spencer Van B. Wilking, MB, BS, MPH; Al Belanger, MA; William B. Kannel, MD, MPH; Ralph B. D'Agostino, PhD; Knight Steel, MD

[+] Author Affiliations

Reprint requests to the Geriatrics Section, Boston University Medical Center, 720 Harrison Ave, Suite 1101, Boston, MA 02118 (Dr Wilking).

JAMA. 1988;260(23):3451-3455. doi:10.1001/jama.1988.03410230069030

Text Size: A A A

Published online

Article

References

ABSTRACT

ABSTRACT | REFERENCES

Isolated systolic hypertension (ISH), defined as systolic blood pressure of 160 mm Hg or greater when the diastolic pressure is less than 95 mm Hg, is a common form of hypertension among the elderly. We collected incidence and prevalence data on ISH and evaluated several potential factors for its occurrence in the Framingham Heart Study during 16 biennial examinations. The factors evaluated were age, sex, all components of the blood pressure (systolic and diastolic blood pressure, pulse pressure, and mean arterial pressure), Metropolitan relative weight, serum cholesterol level, serum uric acid level, cigarette smoking, ventricular heart rate, glucose intolerance, and hematocrit. The population at risk (1687 men and 1992 women) were those members of the Framingham cohort with a systolic blood pressure less than 160 mm Hg in the first four biennial examinations. Results showed ISH in 14.4% of the men and 22.8% of the women. Cumulative incidence rates were 418 per 1000 in men and 533 per 1000 in women. Significant risk factors for ISH were age, sex, all components of the blood pressure, and increased relative weight in women. We conclude that ISH is a highly prevalent disorder. Its major determinants are age, sex, increasing levels of blood pressure, and obesity in women.

(JAMA 1988;260:3451-3455)

REFERENCES

ABSTRACT | REFERENCES

Veterans Administration Cooperative Study on Antihypertensive Agents: Effects of treatment on morbidity in hypertension: I. Results in patients with diastolic blood pressures averaging 115 through 129 mm Hg . JAMA 1967;;202:1028-1034.

Veterans Administration Cooperative Study on Antihypertensive Agents: Effects of treatment on morbidity in hypertension: II. Results in patients with diastolic blood pressure averaging 90 through 114 mm Hg . JAMA 1970;;213:1143-1152.

Smirk FH: The prognosis of untreated and treated hypertension and advantages of early treatment . Am Heart J 1972;;83:825.

Stamler J, Rhomberg P, Schoenberger J, et al: Multivariate analysis of the relationship of seven variables to blood pressure: Findings of the Chicago Heart Association detection project in industry, 1967-1972 . J Chronic Dis 1975;;28:527-548.

Harris T, Cook FE, Kannel WB, et al: Blood pressure experience and risk of cardiovascular disease in the elderly . Hypertension 1985;;7:118.

Forette F, de la Fuente X, Golmard JL, et al: The prognostic significance of isolated systolic hypertension in the elderly: Results of a ten year longitudinal survey . Clin Exp Hypertens A 1982;;4:1177-1191.

Brest AN, Haddad M: Should systolic hypertension be treated? in Corday E (ed): Controversies in Cardiology . Philadelphia, FA Davis Co Publishers, 1978;, pp 217-220.

Colandrea MA, Friedman GD, Niehaman MZ, et al: Systolic hypertension in the elderly: An epidemiologic assessment . Circulation 1970;;41:239-245.

Garland C, Barrett-Connor E, Suarez L, et al: Isolated systolic hypertension and mortality after age 60 years: A prospective population-based study . Am J Epidemiol 1983;;118:365-376.

Wing S, Aubert RE, Hansen JP, et al: Isolated systolic hypertension in Evans county: I. Prevalence and screening considerations . J Chronic Dis 1982;;35:735-742.

Kannel WB, Dawber TR, McGee DL: Perspectives on systolic hypertension: The Framingham study . Circulation 1980;;61:1179-1182.

Hulley SB, Furberg CD, Garland B, et al: Systolic Hypertension in the Elderly Program (SHEP): Antihypertensive efficacy of chlorthalidone . Am J Cardiol 1985;;56:913-920.

The Framingham Heart Study: The Epidemiological Investigation of Cardiovascular Disease , publication (NIH) 74-599. Dept of Health, Education, and Welfare, 1974;, section 30 , pp 17-40.

Hubert HB, Feinleib M, McNamara PM, et al: Obesity as an independent risk factor for cardiovascular disease: A 26-year follow-up of participants in The Framingham Heart Study . Circulation 1983;;67:968-977.

Couples LA, D'Agostino RB, Anderson K, et al: Comparison of baseline and repeated measure covariate techniques in the Framingham Heart Study . Stat Med 1988;;7:205-218.

The Framingham Heart Study: The Epidemiological Investigation of Cardiovascular Disease , publication (NIH) 74-599. Dept of Health, Education, and Welfare, 1974;, section 30 , p 6.

Cox DR: Regression models and life tables . J R Stat Soc 1972;;34(series B):187-220.

SUGI Supplemental Library User's Guide, 1983 Edition . Cary, NC, SAS Institute Inc, 1983;.

National Center for Health Statistics: Blood Pressure of Adults by Race and Area: United States, 1960-1962 . Vital and Health Statistics series 11, No. (5) , US Dept of Health, Education, and Welfare, 1964;.

Molgaard CA, Golbeck AL: Prevalence of isolated systolic hypertension in Alameda County, California . Am J Prev Med 1986;;2:193-197.

Curb JD, Borhani NO, Entwisle G, et al: Isolated systolic hypertension in 14 communities . Am J Epidemiol 1985;;121:362-370.

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal