Systolic versus diastolic blood pressure and risk of coronary heart disease

Kannel, William B.; Gordon, Tavia; Schwartz, Morton A.

doi:10.1016/0002-9149(71)90428-0

Cited by 833 publications

(169 citation statements)

References 19 publications

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“…Typically, the correlation between single measurements of systolic and diastolic blood pressure is about 0.7-0.8 (20). (This is about the same as the correlation between repeated measures of either systolic pressure or diastolic pressure).…”

Section: Systolic Versus Diastolic Blood Pressurementioning

confidence: 95%

“…Efforts to delineate the independent contributions of systolic and of diastolic blood pressure have therefore focussed entirely on crude unadjusted baseline blood pressure measurements from prospective observational studies (20) . In general, these analyses have suggested that systolic blood pressure measured on a single occasion confers additional prognostic information to that conferred by diastolic blood pressure measured on a single occasion.…”

Section: Systolic Versus Diastolic Blood Pressurementioning

confidence: 99%

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The Epidemiological Association between Blood Pressure and Stroke: Implications for Primary and Secondary Prevention

MacMahon

Rodgers

1994

Hypertens Res

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Data from prospective observational studies indicate that usual levels of blood pressure are directly and continuously related to the risk of stroke. The strength of this association has been substantially underestimated by many previous analyses that have not taken account of the "regression dilution bias;" correction for this increases by about 60% the strength of the association between blood pressure levels and stroke risk. From corrected analyses it is apparent that a difference in usual blood pressure levels of just 915 mmHg would ultimately confer about a one-third difference in stroke risk. The associations between blood pressure and stroke risk are of similar size in hypertensives and in normotensives. Moreover, because most strokes occur in normotensives, the stroke avoidance that is likely to be conferred by a downward shift in population blood pressure is actually greater in normotensives than hypertensives. For large populations in which stroke is common, a relatively small change in the average adult blood pressure could have large effects on stroke mortality and morbidity. In China, for example, a decline of 915 mmHg in the average adult blood pressure might be expected to prevent about 400,000 deaths from stroke each year; more than three quarters of the deaths prevented would have occurred in normotensive individuals. For individuals, the benefits of blood pressure reduction are likely to be greatest in those at highest risk of stroke. It is possible that blood pressure reduction among either hypertensives or normotensives with a history of cerebrovascular disease could confer particularly worthwhile effects. This hypothesis requires investigation in a large-scale randomised trial. (Hypertens Res 1994; 17: Suppl. I S23-S32)

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Section: Systolic Versus Diastolic Blood Pressurementioning

confidence: 95%

Section: Systolic Versus Diastolic Blood Pressurementioning

confidence: 99%

The Epidemiological Association between Blood Pressure and Stroke: Implications for Primary and Secondary Prevention

MacMahon

Rodgers

1994

Hypertens Res

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“…1 In 1971, an important paper from the Framingham Heart Study demonstrated that, over the age of 45 years at least, the height of the SBP was a better predictor of cardiovascular risk than the DBP. 2 Below this age there was some uncertainty partly because younger people are at lower cardiovascular risk whatever their blood pressure might be so that the number of cardiovascular events that had occurred was too small for confident conclusions to be drawn.…”

Section: Introductionmentioning

confidence: 99%

Epidemiological, pathophysiological and clinical significance of systolic, diastolic and pulse pressure

Beevers

2004

J Hum Hypertens

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Long-term population surveys and studies of untreated hypertensive patients both strongly suggest that over the age of about 45, the height of the systolic blood pressure is a better predictor of cardiovascular outcome than the diastolic pressure. Research into echocardiographic left ventricular size, endothelial function and thromborheology also back up this supposition. In clinical practice, the treatment of isolated systolic hypertension has been shown to be very worthwhile. There remains some uncertainty as to the relative significance of diastolic blood pressure when it is frankly high, as in severe systo-diastolic hypertension. However some clinicians and epidemiologists have questioned whether diastolic pressure is still worth measuring, given the overwhelming importance of the height of the systolic blood pressure at predicting outcome.

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“…Pulse pressure (PP), defined as the difference between SBP and diastolic BP (DBP), is usually employed to explore this component. In many studies, [3][4][5][6][7][8][9] subjects with higher PP were found to have a higher risk than subjects with lower PP values at the same age. Some of these studies, nevertheless, took into consideration hypertensive patients 10,11 or groups of subjects 12 rather than people from the general population, and the role of gender was often neglected.…”

Section: Introductionmentioning

confidence: 99%

Pulse pressure and coronary mortality in elderly men and women from general population

et al. 2002

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The aim of this work was to evaluate whether pulse pressure (PP) in elderly people is a better predictor of coronary mortality than systolic and diastolic blood pressure taken alone. For this aim, 3282 elderly subjects aged у65 years were studied in a population-based frame. Blood pressure was repeatedly measured and averaged; historical data, anthropometrics, blood tests and 14-year coronary mortality were recorded. Statistics included analysis of covariance, Cox analysis and bivariate vectorial analysis. Coronary mortality in women was predicted by PP (1.01 excess risk/mm Hg PP) and was significantly higher in the 3rd than in the 1st tertile of PP (relative risk 2.90); neither systolic nor diastolic pressure taken alone influenced mortality. When systolic and diastolic pressures were both entered into a Cox model, the former had a positive and

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Systolic versus diastolic blood pressure and risk of coronary heart disease

Cited by 833 publications

References 19 publications

The Epidemiological Association between Blood Pressure and Stroke: Implications for Primary and Secondary Prevention

The Epidemiological Association between Blood Pressure and Stroke: Implications for Primary and Secondary Prevention

Epidemiological, pathophysiological and clinical significance of systolic, diastolic and pulse pressure

Pulse pressure and coronary mortality in elderly men and women from general population

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