What does this research mean for the field?

While the relative increase in coronary heart disease mortality for a given increase in blood pressure is similar across different global populations, the absolute risk at the same blood pressure level varies substantially. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To determine whether the relationship between blood pressure levels and long-term mortality from coronary heart disease differs across distinct global populations.

January 6, 2000New England Journal of Medicine

The Relation between Blood Pressure and Mortality Due to Coronary Heart Disease among Men in Different Parts of the World

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Why the study?

Does the relative and absolute risk of death from CHD in relation to blood pressure vary among different global populations?

Population

12,031 men free of CHD at baseline, from six populations in different parts of the world.

Comparison

Elevated systolic and diastolic blood pressure vs Lower blood pressure levels

Design

Cohort

Follow-up

25 years

Authors

PHPeggy C.W. van den HoogenNational Institute for Public Health and the Environment EFEdith J. M. FeskensPreventive Cardiology NNNico NagelkerkeUnited Arab Emirates University

Discussion

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Implication

Consistent relative CHD mortality risks with BP across populations may inform global models; leaves open absolute risk calibration by region.

Key Points

To determine whether the relationship between blood pressure levels and long-term mortality from coronary heart disease differs across distinct global populations.
Prospective cohort design assessing baseline systolic and diastolic blood pressure in 12,031 men aged 40 to 59 years without baseline coronary heart disease across six global populations.
Followed participants over 25 years to record coronary heart disease mortality (1,291 deaths total), analyzing associations with and without adjustment for within-subject blood pressure variability.
At blood pressure levels of approximately 140/85 mm Hg, age-standardized 25-year coronary heart disease mortality varied more than threefold, reaching approximately 70 deaths per 10,000 person-years in the United States and northern Europe versus approximately 20 per 10,000 person-years in Japan and southern Europe.
The unadjusted relative risk of death from coronary heart disease was 1.17 (95% CI, 1.14 to 1.20) per 10 mm Hg increase in systolic pressure and 1.13 (95% CI, 1.10 to 1.15) per 5 mm Hg increase in diastolic pressure across populations.
Adjustment for within-subject blood pressure variability increased the relative risk of death to 1.28 for both a 10 mm Hg systolic increment and a 5 mm Hg diastolic increment.

Structured PICO

Does the relative and absolute risk of death from CHD in relation to blood pressure vary among different global populations?

Population

12,031 men (age range, 40 to 59 years) free of CHD at baseline, from six populations in different parts of the world.

Intervention

Elevated systolic and diastolic blood pressure

Comparator

Lower blood pressure levels

Outcome

Long-term mortality from CHD over 25 years of follow-uphard clinical

The relative increase in long-term mortality due to CHD for a given increase in blood pressure is similar across different populations, but the absolute risk at the same blood pressure level varies substantially.

Cite This Study

Hoogen et al. (2000) studied this question.

synapsesocial.com/papers/6a1d46c97328fa9a742f40f3 https://doi.org/10.1056/nejm200001063420101

Topics

Hypertension management

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Implication

Consistent relative CHD mortality risks with BP across populations may inform global models; leaves open absolute risk calibration by region.

The Relation between Blood Pressure and Mortality Due to Coronary Heart Disease among Men in Different Parts of the World

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

The Relation between Blood Pressure and Mortality Due to Coronary Heart Disease among Men in Different Parts of the World

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Topics

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