Blood pressure components and cardiovascular events in older adults: the Rotterdam study.
OBJECTIVE
To compare the strength of the relative risks of systolic (SBP) diastolic blood pressure (DBP) and pulse pressure (PP) as predictors of myocardial infarction and stroke in older adults.


METHODS
Prospective cohort study.


METHODS
The Rotterdam Study, a Dutch population-based study.


METHODS
A total of 4,234 subjects aged 55 and older with no previous myocardial infarction (MI) or stroke at baseline.


METHODS
Blood pressure levels at baseline, first MI and stroke, all-cause mortality during follow-up.


RESULTS
During follow-up, 205 subjects had an MI (average follow-up period 7 years), 137 subjects had a stroke (average follow-up period 6.1 years), and 748 subjects died. A 1-standard deviation difference in SBP, DBP, and PP was associated with relative risks of MI of 1.24 (95% confidence interval (CI)=1.06-1.46), 1.07 (0.92-1.25), and 1.25 (1.07-1.48), respectively. Corresponding relative risks for stroke were 1.59 (1.37-1.86), 1.27 (1.10-1.48), and 1.48 (1.27-1.72). For all-cause mortality the corresponding relative risks and 95% CI were 1.21 (1.11-1.31), 1.06 (0.99-1.14), and 1.20 (1.10-1.31).


CONCLUSIONS
The results of this study suggest that, in a population of apparently healthy older adults, PP is not a better predictor of cardiovascular events and all-cause mortality than SBP.
Mattace-Raso
Francesco U S
FU
Section of Geriatric Medicine, Erasmus Medical Center, Rotterdam, the Netherlands.
van der Cammen
Tischa J M
TJ
van Popele
Nicole M
NM
van der Kuip
Deirdre A M
DA
Schalekamp
Maarten A D H
MA
Hofman
Albert
A
Breteler
Monique M B
MM
Witteman
Jacqueline C M
JC
D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D001795:Blood Pressure Determination / Q000379:methods / Q000592:standards*; D002423:Cause of Death; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000175:diagnosis; D015994:Incidence; D008297:Male; D009203:Myocardial Infarction / Q000209:etiology / Q000401:mortality; D009426:Netherlands / Q000453:epidemiology; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011674:Pulse; D012306:Risk; D012307:Risk Factors; D017678:Sex Distribution; D020521:Stroke / Q000209:etiology / Q000401:mortality; D018881:Suburban Health / Q000706:statistics & numerical data