Blood pressure, stroke, and coronary heart disease *1Part 1, prolonged differences in blood pressure: prospective observational studies corrected for the regression dilution bias

摘要: The associations of diastolic blood pressure (DBP) with stroke and coronary heart disease (CHD) were investigated in nine major prospective observational studies: total 420,000 individuals, 843 strokes, 4856 CHD events, 6-25 (mean 10) years follow-up. combined results demonstrate positive, continuous, apparently independent associations, no significant heterogeneity effect among different studies. Within the range DBP studied (about 70-110 mm Hg), there was evidence any "threshold" below which lower levels not associated risks CHD. Previous analyses have described uncorrected measured just at "baseline" subsequent rates. But, because diluting effects random fluctuations DBP, these substantially underestimate true usual (ie, an individual's long-term average DBP) disease. After correction for this "regression dilution" bias, prolonged differences 5, 7.5, 10 Hg respectively least 34%, 46%, 56% less 21%, 29%, 37% These are about 60% greater than previous analyses. (This regression dilution bias is quite general, so analogous corrections to relations cholesterol or various other risk factors diseases would likewise increase their estimated strengths.) suggest that large majority whether conventionally "hypertensive" "normotensive", a should eventually confer vascular