title: Life course trajectories of systolic blood pressure using longitudinal data from eight UK cohorts.
abstract: BACKGROUND
  Much of our understanding of the age-related progression of systolic blood pressure (SBP) comes from cross-sectional data, which do not directly capture within-individual change. We estimated life course trajectories of SBP using longitudinal data from seven population-based cohorts and one predominantly white collar occupational cohort, each from the United Kingdom and with data covering different but overlapping age periods.
  
  
  RESULTS
  Data are from 30,372 individuals and comprise 102,583 SBP observations spanning from age 7 to 80+y. Multilevel models were fitted to each cohort. Four life course phases were evident in both sexes: a rapid increase in SBP coinciding with peak adolescent growth, a more gentle increase in early adulthood, a midlife acceleration beginning in the fourth decade, and a period of deceleration in late adulthood where increases in SBP slowed and SBP eventually declined. These phases were still present, although at lower levels, after adjusting for increases in body mass index though adulthood. The deceleration and decline in old age was less evident after excluding individuals who had taken antihypertensive medication. Compared to the population-based cohorts, the occupational cohort had a lower mean SBP, a shallower annual increase in midlife, and a later midlife acceleration. The maximum sex difference was found at age 26 (+8.2 mm Hg higher in men, 95% CI: 6.7, 9.8); women then experienced steeper rises and caught up by the seventh decade.
  
  
  CONCLUSIONS
  Our investigation shows a general pattern of SBP progression from childhood in the UK, and suggests possible differences in this pattern during adulthood between a general population and an occupational population. Please see later in the article for the Editors' Summary.
authors.affiliation: Medical Research Council Unit for Lifelong Health and Ageing, Department of Epidemiology and Public Health, University College London, London, United Kingdom. a.wills@nshd.mrc.ac.uk
authors.forename: Andrew K
authors.initials: AK
authors.lastname: Wills
authors.forename: Debbie A
authors.initials: DA
authors.lastname: Lawlor
authors.forename: Fiona E
authors.initials: FE
authors.lastname: Matthews
authors.forename: Avan Aihie
authors.initials: AA
authors.lastname: Sayer
authors.forename: Eleni
authors.initials: E
authors.lastname: Bakra
authors.forename: Yoav
authors.initials: Y
authors.lastname: Ben-Shlomo
authors.forename: Michaela
authors.initials: M
authors.lastname: Benzeval
authors.forename: Eric
authors.initials: E
authors.lastname: Brunner
authors.forename: Rachel
authors.initials: R
authors.lastname: Cooper
authors.forename: Mika
authors.initials: M
authors.lastname: Kivimaki
authors.forename: Diana
authors.initials: D
authors.lastname: Kuh
authors.forename: Graciela
authors.initials: G
authors.lastname: Muniz-Terrera
authors.forename: Rebecca
authors.initials: R
authors.lastname: Hardy
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D001794:Blood Pressure / Q000502:physiology*; D015992:Body Mass Index; D002648:Child; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012727:Sex Characteristics; D006113:United Kingdom