학술논문
Effects of elevated systolic blood pressure on ischemic heart disease: a Burden of Proof study.
Document Type
Academic Journal
Author
Razo C; Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA. razoc@uw.edu.; Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA. razoc@uw.edu.; Welgan CA; Johns Hopkins University School of Medicine, Baltimore, MD, USA.; Johnson CO; Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.; McLaughlin SA; Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.; Iannucci V; Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.; Rodgers A; The George Institute for Global Health, The University of New South Wales, Sydney, New South Wales, Australia.; Wang N; The George Institute for Global Health, The University of New South Wales, Sydney, New South Wales, Australia.; LeGrand KE; Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.; Sorensen RJD; Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.; He J; Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.; Zheng P; Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.; Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA.; Aravkin AY; Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.; Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA.; Department of Applied Mathematics, University of Washington, Seattle, WA, USA.; Hay SI; Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.; Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA.; Murray CJL; Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.; Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA.; Roth GA; Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.; Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA.; Division of Cardiology, University of Washington, Seattle, WA, USA.
Source
Publisher: Nature Publishing Company Country of Publication: United States NLM ID: 9502015 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1546-170X (Electronic) Linking ISSN: 10788956 NLM ISO Abbreviation: Nat Med Subsets: MEDLINE
Subject
Language
English
Abstract
High systolic blood pressure (SBP) is a major risk factor for ischemic heart disease (IHD), the leading cause of death worldwide. Using data from published observational studies and controlled trials, we estimated the mean SBP-IHD dose-response function and burden of proof risk function (BPRF), and we calculated a risk outcome score (ROS) and corresponding star rating (one to five). We found a very strong, significant harmful effect of SBP on IHD, with a mean risk-relative to that at 100 mm Hg SBP-of 1.39 (95% uncertainty interval including between-study heterogeneity 1.34-1.44) at 120 mm Hg, 1.81 (1.70-1.93) at 130 mm Hg and 4.48 (3.81-5.26) at 165 mm Hg. The conservative BPRF measure indicated that SBP exposure between 107.5 and 165.0 mm Hg raised risk by 101.36% on average, yielding a ROS of 0.70 and star rating of five. Our analysis shows that IHD risk was already increasing at 120 mm Hg SBP, rising steadily up to 165 mm Hg and increasing less steeply above that point. Our study endorses the need to prioritize and strengthen strategies for screening, to raise awareness of the need for timely diagnosis and treatment of hypertension and to increase the resources allocated for understanding primordial prevention of elevated blood pressure.
(© 2022. The Author(s).)
(© 2022. The Author(s).)