Change in blood pressure and 5-year risk of coronary heart disease among elderly men: the Finnish cohorts of the Seven Countries Study.
OBJECTIVE
To study the association between blood pressure and change in blood pressure with future coronary risk among elderly men.


METHODS
Cohort study.


METHODS
Finnish cohorts of the Seven Countries Study.


METHODS
Four hundred and seventy-six men aged 65-84 years and free of clinically manifested coronary heart disease at baseline, in 1984.


METHODS
Fatal myocardial infarction (n = 29), any myocardial infarction (n = 42), and incidence of any new signs and symptoms of coronary heart disease (n = 80) during a 5-year follow-up.


RESULTS
In multivariate analysis, a significant inverse U-shaped relationship was observed between baseline diastolic blood pressure and future fatal myocardial infarction, any myocardial infarction and any coronary heart disease. In models predicting the risk of coronary heart disease during 1984-1989, there was a significant interaction between both systolic (SBP) and diastolic blood pressure (DBP) in 1969-1974 and change in blood pressure between 1969-1974 and 1984. In categorical analyses, men (n = 42) who experienced a decline in DBP of > or = 4 mmHg from initial levels of > or = 90 mmHg had a higher risk of any myocardial infarction than men (n = 112) with a change of < 4 mmHg (odds ratio 4.5). For a decline of > or = 10 mmHg or more in SBP from levels of > or = 160 mmHg the corresponding odds ratio was 2.9. Men who experienced a decline in DBP or SBP from normotensive levels or an increase in blood pressure had no excess risk compared with men with stabile (change in DBP < 4 mmHg and change in SBP < 10 mmHg) blood pressure values.


CONCLUSIONS
The present results suggest that among elderly men a decline in DBP or SBP from previously hypertensive levels may be associated with increased coronary risk.
Tervahauta
M
M
Department of Community Health and General Practice, University of Kuopio, Finland.
Pekkanen
J
J
Enlund
H
H
Nissinen
A
A
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure; D015331:Cohort Studies; D003327:Coronary Disease / Q000209:etiology* / Q000401:mortality; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000503:physiopathology*; D008297:Male; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000209:etiology* / Q000401:mortality; D012189:Retrospective Studies; D012307:Risk Factors
D000959:Antihypertensive Agents