title: Antecedent blood pressure as a predictor of cardiovascular disease.
abstract: Elevated blood pressure (BP) is associated with greater risk of cardiovascular disease (CVD), and evidence suggests that prior BP levels may be at least as important as current BP in prediction models. We analyzed the determinants of CVD risk in Offspring Framingham Heart Study participants (n = 3344). The baseline Cox model included the traditional risk factors and current systolic BP to predict 20-year risk of CVD (643 events). Current systolic BP was significant, and the associated hazard ratio was 1.09 for 10 mm Hg (confidence interval [CI] 95%: 1.04-1.15). A second model used the traditional risk factors plus antecedent BP (hazard ratio [HR] = 1.19; CI 95%: 1.10-1.24). In a third model that included traditional risk factors and both current and antecedent BP, the antecedent BP was significant (HR = 1.18; CI 95%: 1.08-1.23), but the current BP was not statistically significant (HR = 1.01; CI 95%: 0.97-1.09). Antecedent BP showed a significantly stronger effect on risk of CVD than current BP.
authors.affiliation: H. Milton Stewart School of Industrial & Systems Engineering, Georgia Institute of Technology, Atlanta, GA, USA.
authors.forename: Anthony
authors.initials: A
authors.lastname: Bonifonte
authors.affiliation: H. Milton Stewart School of Industrial & Systems Engineering, Georgia Institute of Technology, Atlanta, GA, USA.
authors.forename: Turgay
authors.initials: T
authors.lastname: Ayer
authors.affiliation: Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USA.
authors.forename: Emir
authors.initials: E
authors.lastname: Veledar
authors.affiliation: Department of Mathematics, Texas Lutheran University, Seguin, TX, USA.
authors.forename: Allison
authors.initials: A
authors.lastname: Clark
authors.affiliation: Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USA. Electronic address: pwwilso@emory.edu.
authors.forename: Peter W F
authors.initials: PW
authors.lastname: Wilson
mesh_terms: D001794:Blood Pressure / Q000502:physiology*; D002318:Cardiovascular Diseases / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D018570:Risk Assessment; D012307:Risk Factors; D013599:Systole / Q000502:physiology*
keywords: Hypertension; statistics