Table 2.
Incidence rates and hazard ratios for fatal coronary heart disease and non-fatal myocardial infarction, all-cause mortality, stroke, and heart failure associated with standard deviation of systolic blood pressure.
| Quintile of standard deviation of SBP, mmHg | ||||||
|---|---|---|---|---|---|---|
| Q1 (<6.5) | Q2 (6.5 to <8.7) | Q3 (8.7 to <11.0) | Q4 (11.0 to <14.4) | Q5 (≥14.4) | p-trend | |
| Fatal CHD and non-fatal MI (1194 events total) | ||||||
| Number of cases | 203 | 199 | 234 | 244 | 314 | - |
| Incidence rate* (95% CI) | 14.5 (12.4–16.5) | 14.2 (12.1–16.3) | 16.3 (14.0–18.5) | 17.1 (14.9–19.3) | 22.7 (20.0–25.4) | <0.001 |
| Hazard ratio | ||||||
| Model 1 | 1 (ref) | 0.98 (0.80–1.21) | 1.10 (0.90–1.35) | 1.15 (0.95–1.40) | 1.53 (1.28–1.84) | <0.001 |
| Model 2 | 1 (ref) | 0.97 (0.79–1.19) | 1.07 (0.87–1.31) | 1.12 (0.92–1.36) | 1.46 (1.21–1.76) | <0.001 |
| Model 3 | 1 (ref) | 0.95 (0.77–1.16) | 1.03 (0.84–1.26) | 1.05 (0.86–1.28) | 1.30 (1.07–1.59) | 0.005 |
| Model 4 | 1 (ref) | 0.95 (0.77–1.16) | 1.03 (0.84–1.26) | 1.05 (0.86–1.28) | 1.30 (1.06–1.59) | 0.006 |
| All-cause mortality (1948 events total) | ||||||
| Number of cases | 259 | 331 | 389 | 412 | 557 | - |
| Incidence rate* (95% CI) | 17.9 (15.5–20.3) | 22.9 (20.2–25.5) | 26.0 (23.1–28.9) | 27.6 (24.8–30.4) | 38.2 (34.9–41.5) | <0.001 |
| Hazard ratio | ||||||
| Model 1 | 1 (ref) | 1.25 (1.05–1.49) | 1.35 (1.12–1.62) | 1.41 (1.19–1.67) | 1.85 (1.57–2.19) | <0.001 |
| Model 2 | 1 (ref) | 1.24 (1.04–1.47) | 1.31 (1.09–1.58) | 1.36 (1.15–1.61) | 1.75 (1.47–2.07) | <0.001 |
| Model 3 | 1 (ref) | 1.21 (1.02–1.45) | 1.26 (1.05–1.52) | 1.27 (1.07–1.51) | 1.55 (1.29–1.86) | <0.001 |
| Model 4 | 1 (ref) | 1.21 (1.02–1.45) | 1.27 (1.05–1.53) | 1.28 (1.08–1.52) | 1.58 (1.32–1.90) | <0.001 |
| Stroke (606 events total) | ||||||
| Number of cases | 79 | 96 | 117 | 137 | 177 | - |
| Incidence rate* (95% CI) | 5.6 (4.3–6.8) | 6.8 (5.4–8.3) | 8.1 (6.6–9.7) | 9.5 (7.8–11.3) | 12.6 (10.7–14.6) | <0.001 |
| Hazard ratio | ||||||
| Model 1 | 1 (ref) | 1.18 (0.87–1.62) | 1.34 (1.00–1.81) | 1.52 (1.12–2.07) | 1.87 (1.40–2.52) | <0.001 |
| Model 2 | 1 (ref) | 1.17 (0.86–1.60) | 1.29 (0.96–1.74) | 1.50 (1.11–2.04) | 1.80 (1.34–2.42) | <0.001 |
| Model 3 | 1 (ref) | 1.15 (0.85–1.57) | 1.22 (0.91–1.65) | 1.39 (1.01–1.90) | 1.52 (1.12–2.08) | 0.004 |
| Model 4 | 1 (ref) | 1.15 (0.84–1.57) | 1.22 (0.90–1.64) | 1.36 (0.99–1.87) | 1.46 (1.06–2.01) | 0.013 |
| Heart failure (921 events total) | ||||||
| Number of cases | 136 | 156 | 188 | 196 | 245 | - |
| Incidence rate* (95% CI) | 9.7 (7.9–11.5) | 11.1 (9.3–13.0) | 13.1 (11.1–15.0) | 13.7 (11.7–15.7) | 17.6 (15.4–19.9) | <0.001 |
| Hazard ratio | ||||||
| Model 1 | 1 (ref) | 1.12 (0.87–1.44) | 1.26 (0.99–1.59) | 1.30 (1.01–1.66) | 1.62 (1.29–2.04) | <0.001 |
| Model 2 | 1 (ref) | 1.10 (0.86–1.42) | 1.21 (0.95–1.54) | 1.27 (0.99–1.62) | 1.56 (1.24–1.97) | <0.001 |
| Model 3 | 1 (ref) | 1.07 (0.83–1.37) | 1.12 (0.88–1.43) | 1.11 (0.86–1.43) | 1.22 (0.95–1.57) | 0.125 |
| Model 4 | 1 (ref) | 1.07 (0.83–1.38) | 1.13 (0.89–1.44) | 1.12 (0.87–1.45) | 1.25 (0.97–1.61) | 0.084 |
Per 1,000 person-years
CI – confidence interval; SBP – systolic blood pressure; p-y – person years.
Model 1 includes adjustment for age, gender, race/ethnicity, region of residence and randomization assignment.
Model 2 includes variables in model 1 and smoking status, body mass index, estimated glomerular filtration rate, diabetes, total cholesterol, history of myocardial infarction or stroke, history of coronary revascularization, atrial fibrillation on electrocardiogram, history of other atherosclerotic cardiovascular disease, major ST depression or T wave inversion, left ventricular hypertrophy, low high density lipoprotein cholesterol, aspirin use, statin use, use of blood pressure medications prior to study randomization and years of education.
Model 3 includes variables in model 2 and pulse pressure, medication adherence, antihypertensive medication classes being taken, and changes in antihypertensive medication classes being taken.
Model 4 includes variables in model 3 and mean systolic blood pressure.