| Content Provider |
World Health Organization (WHO)-Global Index Medicus |
| Author |
Mohseni, Hamid Emdin, Connor A. Woodward, Mark Rahimi, Kazem Salimi-khorshidi, Gholamreza Anderson, Simon G. Callender, Thomas Conrad, Nathalie |
| Description |
Author Affiliation: Emdin CA ( The George Institute for Global Health, Oxford Martin School, University of Oxford, Oxford OX1 3DB, UK.); Anderson SG ( The George Institute for Global Health, Oxford Martin School, University of Oxford, Oxford OX1 3DB, UK.); Callender T ( The George Institute for Global Health, Oxford Martin School, University of Oxford, Oxford OX1 3DB, UK.); Conrad N ( The George Institute for Global Health, Oxford Martin School, University of Oxford, Oxford OX1 3DB, UK.); Salimi-Khorshidi G ( The George Institute for Global Health, Oxford Martin School, University of Oxford, Oxford OX1 3DB, UK.); Mohseni H ( The George Institute for Global Health, Oxford Martin School, University of Oxford, Oxford OX1 3DB, UK.); Woodward M ( The George Institute for Global Health, University of Sydney, Sydney, Australia Department of Epidemiology, Johns Hopkins University, Baltimore, MD, USA.); Rahimi K ( The George Institute for Global Health, Oxford Martin School, University of Oxford, Oxford OX1 3DB, UK Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK kazem.rahimi@cardiov.ox.ac.uk.); |
| Abstract |
Objectives To determine the subgroup specific associations between usual blood pressure and risk of peripheral arterial disease, and to examine the relation between peripheral arterial disease and a range of other types of vascular disease in a large contemporary cohort. Design Cohort study. Setting Linked electronic health records from 1990 to 2013 in the United Kingdom. Participants 4 222 459 people aged 30-90 years, registered at a primary care practice for at least one year and with a blood pressure measurement. Main outcome measures Time to first diagnosis of new onset peripheral arterial disease and time to first diagnosis of 12 different vascular events. Results A 20 mm Hg higher than usual systolic blood pressure was associated with a 63% higher risk of peripheral arterial disease (hazard ratio 1.63, 95% confidence interval 1.59 to 1.66). The strength of the association declined with increasing age and body mass index (P<0.001 for interaction) but was not modified by sex or smoking status. Peripheral arterial disease was associated with an increased risk of 11 different vascular events, including ischaemic heart disease (1.68, 1.58 to 1.79), heart failure (1.63, 1.52 to 1.75), aortic aneurysm (2.10, 1.79 to 2.45), and chronic kidney disease (1.31, 1.25 to 1.38), but not haemorrhagic stroke. The most common initial vascular event among those with peripheral arterial disease was chronic kidney disease (24.4% of initial events), followed by ischaemic heart disease (18.5% of initial events), heart failure (14.7%), and atrial fibrillation (13.2%). Overall estimates from this cohort were consistent with those derived from traditional studies when we pooled the findings in two meta-analyses. Conclusions Raised blood pressure is a strong risk factor for peripheral arterial disease in a range of patient subgroups. Furthermore, clinicians should be aware that those with established peripheral arterial disease are at an increased risk of a range of other vascular events, including chronic kidney disease, ischaemic heart disease, heart failure, atrial fibrillation, and stroke. |
| ISSN |
09598138 |
| e-ISSN |
17561833 |
| Journal |
BMJ (British Medical Journal) |
| Volume Number |
351 |
| Language |
English |
| Publisher |
British Medical Journal Publishing Group |
| Publisher Date |
2015-09-01 |
| Publisher Place |
Great Britain (UK) |
| Access Restriction |
Open |
| Subject Keyword |
Blood Pressure Hypertension Epidemiology Peripheral Arterial Disease Vascular Diseases Age Distribution Body Mass Index Complications Prevention & Control Etiology Prospective Studies Risk Factors Meta-Analysis Research Support, Non-U.S. Gov't Medicine |
| Content Type |
Text |
| Resource Type |
Article |
