The relationship of obesity and the development of coronary heart disease to longitudinal changes in systolic blood pressure

In an investigation of the relationship of obesity and the development of c oronary heart disease (CHD) to longitudinal changes in systolic blood press ure (SBP), a sample of 1029 male participants from the Baltimore Longitudin al Study of Baltimore (BLSA), who were free of CHD at the beginning of the study, were examined with a total of 4111 examinations (mean of four examin ations per person) conducted during the study period. The mean follow-up ti me was 8.1 years with a maximum of 16 examinations and 30.9 years of follow -up. Luring the follow-up period, 192 participants developed CHD, and these participants' data collected after the CHD event were Excluded from the an alysis. A proportional hazards regression model was used to calculate the r elative risk of developing CHD for several CHD risk factors. Both simple an d multiple proportional hazards regression models indicate a strong associa tion between body mass index: (BMI), cholesterol cigarette smoking, and sys tolic blood pressure (SBP) with the risk of developing CHD. In addition, a linear mixed-effects model was used to examine changes in SEP measurements over time and to identify factors, including the age at first examination a nd time in study that are related to that change. The results from the line ar mixed-effecs model analysis indicate that those in. the obese group (BMI greater than or equal to 30 kg/m(2)) have SEP measurements that are on ave rage 9.0 mm Hg higher than those in. the normal group (20 less than or equa l to BMI < 25). Also, SPB measurements were on average 6.6 mm Hg higher in those who developed CHD during the study period than those who remained fre e of disease. In addition, SPB showed a quadratic relationship with time, a nd its patterns of change with time were different among the different age groups. Also, the relationship between changes in. SEP with respect to chol esterol was dependent on time in the study as well.