PMID- 15879322
OWN - NLM
STAT- MEDLINE
DCOM- 20060118
LR  - 20220408
IS  - 1524-4628 (Electronic)
IS  - 0039-2499 (Linking)
VI  - 36
IP  - 6
DP  - 2005 Jun
TI  - Association of blood pressure indices and stroke mortality in isolated systolic 
      hypertension.
PG  - 1288-90
AB  - BACKGROUND AND PURPOSE: Isolated systolic hypertension (ISH), systolic blood 
      pressure (BP) > or =160 mm Hg and diastolic BP (DBP) <90 mm Hg, is associated 
      with stroke; however, the correlation between specific BP indices and stroke 
      mortality in ISH is not defined. METHODS: In a pooled analysis of 9 
      epidemiological studies, we examined whether pulse pressure (PP) was more 
      predictive of stroke mortality than systolic BP (SBP), DBP, or mean BP (MAP) in 
      persons with ISH. Subjects (n=682; 29% male; 77% white; mean age 63.6 years) with 
      ISH, free of cardiovascular disease, and not on antihypertensive drug therapy at 
      baseline were followed a mean of 13.0+/-7.3 years, and 54 stroke deaths occurred. 
      The relative importance of each BP index was compared by the decrease in the -2 
      log likelihood (a measure of model agreement with data) because of the addition 
      of 1 or a combination of BP indices to a Cox regression model. Hazards ratios 
      (HRs) for fatal stroke for a 1-SD in BP index were determined. RESULTS: PP was 
      the best predictor of stroke mortality based on the decrease in the -2 log 
      likelihood (10.65; P=0.001; HR=1.52), followed by SBP (7.19; P=0.007; HR=1.40), 
      DBP (2.76; P=0.10; HR=0.80), or MAP (0.39; P=0.39; HR=1.10). Any combination of 
      BP indices did not exceed a decrease in the -2 log likelihood of 10.72. 
      CONCLUSIONS: These data suggest that in persons with ISH, PP is a better 
      predictor of fatal stroke than SBP, DBP, or MAP.
FAU - Paultre, Furcy
AU  - Paultre F
AD  - Columbia University, College of Physicians and Surgeons, PH 10-203, 622 W 168th 
      St, New York, NY 10032, USA.
FAU - Mosca, Lori
AU  - Mosca L
LA  - eng
GR  - KO8 HL 03681/HL/NHLBI NIH HHS/United States
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
PT  - Research Support, U.S. Gov't, P.H.S.
DEP - 20050505
PL  - United States
TA  - Stroke
JT  - Stroke
JID - 0235266
RN  - 0 (Antihypertensive Agents)
SB  - IM
MH  - Aged
MH  - Antihypertensive Agents/therapeutic use
MH  - *Blood Pressure
MH  - Cohort Studies
MH  - Diastole
MH  - Female
MH  - Humans
MH  - Hypertension/*complications/epidemiology/*mortality
MH  - Male
MH  - Middle Aged
MH  - Proportional Hazards Models
MH  - Stroke/epidemiology/*mortality/pathology
MH  - *Systole
EDAT- 2005/05/10 09:00
MHDA- 2006/01/19 09:00
CRDT- 2005/05/10 09:00
PHST- 2005/05/10 09:00 [pubmed]
PHST- 2006/01/19 09:00 [medline]
PHST- 2005/05/10 09:00 [entrez]
AID - 01.STR.0000166201.79222.4d [pii]
AID - 10.1161/01.STR.0000166201.79222.4d [doi]
PST - ppublish
SO  - Stroke. 2005 Jun;36(6):1288-90. doi: 10.1161/01.STR.0000166201.79222.4d. Epub 
      2005 May 5.