Original ArticlePositional Change in Blood Pressure and 8-Year Risk of Hypertension: The CARDIA Study
Section snippets
SUBJECTS AND METHODS
The study population was derived from 5115 participants in the Coronary Artery Risk Development in Young Adults (CARDIA) study who were between 18 and 30 years of age in 1985-1986 (year 0), at which time they underwent an initial interview and measurement of clinical factors associated with the development of coronary artery disease. The methods of these measurements have been published previously.7 Among the original 5115 CARDIA participants from year 0, 2781 (54%) had complete data from
RESULTS
The sociodemographic and clinical characteristics of participants in each of the 3 standing blood pressure groups are shown in Table 1; 26.6% of participants were in the drop group, 57.2% in the same group, and 16.2% in the rise group. Small but significant differences were noted in the distribution by sex and race groups. Twenty percent of black men and 19% of white men were in the rise group compared with 15% of black women and 13% of white women (P=.004 for race-sex distribution within the
DISCUSSION
We found a clear association between increase in blood pressure on standing and 8-year incidence of hypertension, before and after adjustment for potentially confounding variables. This association was present in all sex-race groups in our biracial cohort of young adults, although it was of only borderline significance in white men. Although numerous studies have shown a strong association between resting blood pressure and future risk of developing hyper-tension,9, 10, 11, 12 few previous
CONCLUSIONS
An increase in blood pressure on standing of more than 5 mm Hg in our biracial cohort of young adults identified a group at increased risk of developing hypertension over the subsequent 8 years. Given the relatively low prevalence of hypertension in the CARDIA population to date and therefore the low positive predictive value for blood pressure change on standing, longer follow-up is needed for a better assessment of the value of this clinical sign as a predictive risk factor for hypertension.
REFERENCES (33)
- et al.
Relation of blood pressure measured in several positions to the subsequent development of systemic hypertension: the Normative Aging Study
Am J Cardiol
(1986) - et al.
Does orthostatic testing have any role in the evaluation of the young subject with mild hypertension? an insight from the HARVEST study
Am J Hypertens
(1997) Essential hypertension: neural considerations
Med Clin North Am
(1987)- et al.
Sympathetic overactivity in hypertension: a moving target
Am J Hypertens
(1996) - et al.
Ethnic difference in hemodynamic responses to stress in hypertensive men and women
Am J Hypertens
(1995) - et al.
Postural changes in diastolic blood pressure and the risk of myocardial infarction: the Normative Aging Study
Circulation
(1984) - et al.
The association of postural changes in systolic blood pressure and mortality in persons with hypertension: the Hypertension Detection and Follow-up Program experience
Circulation
(1987) - et al.
High stress responsivity predicts later blood pressure only in combination with positive family history and high life stress
Hypertension
(1999) - et al.
Postural change in blood pressure and incident hypertension: the ARIC study [abstract]
Circulation
(1995) - et al.
Descriptive epidemiology of blood pressure response to change in body position: the ARIC study
Hypertension
(1999)
Cardiovascular risk factors in young adults: the CARDIA baseline monograph
Control Clin Trials
Proposed hostility and pharisaic-virtue scales for the MMPI
J Appl Psychol
Chronic disease in former college students, VIII: characteristics in youth predisposing to hypertension in later years
Am J Epidemiol
Patterns and predictors of hypertension incidence among Hispanics and non-Hispanic whites: the San Luis Valley Diabetes Study
J Hypertens
Hemodynamic predictors of incident hypertension: the Framingham Heart Study
Hypertension
Predictors of blood pressure and left ventricular mass in the young: the Hypertension in Pregnancy Offspring Study
Am J Hypertens
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This work was supported by grants N01HC-48047, N01HC-48048, N01HC-48049, N01HC-48050, and N01HC-95095 from the National Heart, Lung, and Blood Institute.