SYSTOLIC BLOOD-PRESSURE, ISOLATED SYSTOLIC HYPERTENSION AND RISK OF CORONARY HEART-DISEASE, STROKES, CARDIOVASCULAR-DISEASE AND ALL-CAUSE MORTALITY IN THE MIDDLE-AGED POPULATION

Objective To determine the risk of death from coronary heart disease, stroke, all cardiovascular disease and all-cause mortality associated with systolic blood pressure and in particular with isolated systolic hypertension among the middle-aged population. Methods and design A pr ospective 15-year cohort study of two independent cross-sectional rand om samples of subjects participating in baseline surveys in 1972 and 1 977, Each survey included a self-administered questionnaire, measureme nts of height, weight and blood pressure and the determination of the serum cholesterol concentration, Setting North Karelia and Kuopio prov inces in eastern Finland. Mortality follow-up complete with the person al identification number. Participants Participants were 10 333 men an d 11 160 women aged 25-64 years without histories of myocardial infarc tion and stroke incidence at the time of the baseline survey, Isolated systolic hypertension in these analyses was defined as systolic blood pressure greater than or equal to 160 mmHg and diastolic blood pressu re < 95 mmHg, Subjects with blood pressure <160/90 mmHg were considere d normotensive. Results Coronary heart disease, stroke, cardiovascular disease and all-cause mortality among men and women aged 45-64 years increased with the increasing systolic blood pressure. Among women age d 45-64 years, isolated systolic hypertension increased the relative r isk of these fatal events, Among men aged 45-64 years, only coronary h eart disease mortality was significantly associated with isolated syst olic hypertension, Conclusion Isolated systolic hypertension is an imp ortant predictor of death from coronary heart disease, stroke, cardiov ascular disease and all causes for women. For men aged 45-64 years, th e risk of death from coronary heart disease was associated with isolat ed systolic hypertension, but the risk of stroke, cardiovascular disea se and all-cause mortality associated with increasing systolic blood p ressure was evident already at the systolic blood pressure levels <160 mmHg, independently of the level of diastolic blood pressure. (C) 199 8 Lippincott-Raven Publishers.