Use of Long-term Cumulative Blood Pressure in Cardiovascular Risk Prediction Models

Pool, Lindsay R.; Ning, Hongyan; Wilkins, John T.; Lloyd‐Jones, Donald M.; Allen, Norrina B.

doi:10.1001/jamacardio.2018.2763

Cited by 63 publications

(55 citation statements)

References 14 publications

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“…The mechanism of FSK in ameliorating atherosclerosis might be complex, with potential modulation on the multiple risk factors and cell components of heterogeneity. [21][22][23] Here, FSK treatment did not alter blood pressure, bodyweight or plasma lipids ( Figure S4 and Table S1). However, FSK enhanced endothelial repairing capacity in athero-prone region (Figure 6), consistent with its activity in pro-endothelial proliferation (Figure 3).…”

Section: Discussionmentioning

confidence: 87%

The cyclic adenosine monophosphate elevating medicine, forskolin, reduces neointimal formation and atherogenesis in mice

Hao

Chen

et al. 2020

J Cellular Molecular Medi

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Neointimal formation and atherogenesis are major vascular complications following percutaneous coronary intervention, and there is lack of pharmacological therapy. This study was aimed to examine the effect of forskolin (FSK), a cyclic adenosine monophosphate (cAMP)‐elevating agent, on vascular response to angioplasty wire injury and on atherogenesis in mice. Forskolin treatment reduced neointima formation at 7 and 28 days after wire injury. Early morphometrics of the injured vessels revealed that FSK treatment enhanced endothelial repair and reduced inflammatory cell infiltration. In vitro treatment of primary aortic cells with FSK, at 3‐100 μmol/L, increased endothelial cell proliferation, whereas FSK, at 30‐100 μmol/L, inhibited smooth muscle cell proliferation. FSK inhibited lipopolysaccharide‐induced leucocyte‐endothelial interaction in vitro and in vivo. In a mouse model of atherosclerosis driven by dyslipidaemia and hypertension, FSK administration increased endothelial repair and reduced atherosclerotic plaque formation, without affecting blood pressure, plasma lipids or aortic aneurysms formation. In summary, FSK, at doses relevant to human therapeutic use, protects against neointimal hyperplasia and atherogenesis, and this is attributable to its activities on pro‐endothelial repair and anti‐inflammation. This study raises a potential of clinical use of FSK as an adjunct therapy to prevent restenosis and atherosclerosis after percutaneous coronary intervention.

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Section: Discussionmentioning

confidence: 87%

The cyclic adenosine monophosphate elevating medicine, forskolin, reduces neointimal formation and atherogenesis in mice

Hao

Chen

et al. 2020

J Cellular Molecular Medi

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“…Participants with antihypertensive medication prescribed before the index date were excluded as the duration of hypertension since initial diagnosis or dose and types of an-tihypertensive medications prescribed may have effects on both blood pressure levels and CVD risk. 31 Nevertheless, in an attempt to determine whether pharmacological management may be associated with a lower risk of CVD particularly among patients with stage 1 hypertension, a stratified analysis according to subgroups of antihypertensive medication prescription within the first 5 years of follow-up was conducted. Although patients with stage 1 hypertension not taking antihypertensive medications had higher risk of CVD, those who were prescribed antihypertensives did not have increased CVD risk compared with their respective normal blood pressure groups.…”

Section: Discussionmentioning

confidence: 99%

Association of Blood Pressure Classification in Korean Young Adults According to the 2017 American College of Cardiology/American Heart Association Guidelines With Subsequent Cardiovascular Disease Events

Son

Choi

Kim

et al. 2018

JAMA

188

138

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“…Thus, they offer direct information not used by extant models. While seemingly trivial, integration of longitudinal data into such prediction models has proven to be challenging [16]. To the best of our knowledge, our study is the first to leverage longitudinal blood pressure measurements to significantly improve CV risk prediction.…”

Section: Discussionmentioning

confidence: 99%

“…While our analysis is limited due to the retrospective nature of the data, our careful validations illustrate the usefulness of integrating regularly collected longitudinal data into prediction models. Recently, Pool et al[16] examined whether incorporating cumulative SBP measures that summarize SBP levels collected over time improve atherosclerotic cardiovascular disease prediction. Their results show only modest improvement by incorporating cumulative SBP in the prediction as compared to a single SBP measure.…”

Section: Discussionmentioning

confidence: 99%

Personalized prediction of adverse heart and kidney events using baseline and longitudinal data from SPRINT and ACCORD

et al. 2019

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Background The 2017 guidelines of the American College of Cardiology and the American Heart Association propose substantial changes to hypertension management. The guidelines lower the blood pressure threshold defining hypertension and promote more aggressive treatments. Thus, more individuals are now classified as hypertensive and as a result, medication usage may become more extensive. An inevitable byproduct of greater medication use is higher incidence of adverse effects. Here, we examined these issues by developing models that predict both cardiovascular events and other adverse events based on the treatment chosen and other patient’s data. Methods and results We used data from the SPRINT trial to produce patient-specific predictions of the risks for adverse cardiovascular or kidney outcomes. Unlike prior models, we used both the baseline characteristics collected upon recruitment and the longitudinal data during the follow-up. Importantly, our cardiovascular predictor outperformed extant models on SPRINT participants, achieving AUC = 0.765, and was validated with good performance in an independent cohort of the ACCORD trial. Conclusions Our study illustrates the importance of including longitudinal data for assessing personalized risk and provides means for recommending personalized treatment decisions.

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Use of Long-term Cumulative Blood Pressure in Cardiovascular Risk Prediction Models

Abstract: Using long-term measures of cumulative blood pressure, instead of single measurements, can modestly improve the ability of cardiovascular disease risk prediction models to correctly classify individuals in terms of their risk for cardiovascular disease.

Cited by 63 publications

References 14 publications

The cyclic adenosine monophosphate elevating medicine, forskolin, reduces neointimal formation and atherogenesis in mice

The cyclic adenosine monophosphate elevating medicine, forskolin, reduces neointimal formation and atherogenesis in mice

Association of Blood Pressure Classification in Korean Young Adults According to the 2017 American College of Cardiology/American Heart Association Guidelines With Subsequent Cardiovascular Disease Events

Personalized prediction of adverse heart and kidney events using baseline and longitudinal data from SPRINT and ACCORD

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