Positional change in blood pressure and 8-year risk of hypertension: the CARDIA Study.
OBJECTIVE
To assess the relationship between positional blood pressure change and 8-year incidence of hypertension in a biracial cohort of young adults.


METHODS
Participants from the Coronary Artery Risk Development in Young Adults (CARDIA) study with complete data from year 2 (1987-1988), year 5 (1990-1991), year 7 (1992-1993), and year 10 (1995-1996) examinations were included (N = 2781). Participants were classified into 3 groups based on their year 2 systolic blood pressure response to standing: drop, a decrease in systolic blood pressure of more than 5 mm Hg; same, a change of between -5 and +5 mm Hg; and rise, more than 5-mm Hg increase.


RESULTS
The number of participants in each group was as follows: drop, 741; same, 1590; and rise, 450. The 8-year incidence of hypertension was 8.4% in the drop group, 6.8% in the same group, and 12.4% in the rise group (P < .001). Adjusted odds ratios for developing hypertension during the follow-up period in the rise group vs the same group were as follows: in black men, 2.85 (95% confidence interval [CI], 1.43-5.69), in black women, 2.47 (95% CI, 1.19-5.11), in white men, 2.17 (95% CI, 1.00-4.73), and in white women, 4.74 (95% CI, 1.11-20.30).


CONCLUSIONS
A greater than 5-mm Hg increase in blood pressure on standing identified a group of young adults at increased risk of developing hypertension within 8 years. These findings support a physiologic link between sympathetic nervous system reactivity and risk of hypertension in young adults.
Thomas
Randal J
RJ
Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, Minn 55905, USA. thomas.randal@mayo.edu
Liu
Kiang
K
Jacobs
David R
DR
Bild
Diane E
DE
Kiefe
Catarina I
CI
Hulley
Stephen B
SB
D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D001794:Blood Pressure / Q000502:physiology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000208:ethnology / Q000503:physiopathology*; D015994:Incidence; D016015:Logistic Models; D008297:Male; D011187:Posture / Q000502:physiology*; D012307:Risk Factors; D044465:White People / Q000706:statistics & numerical data