Longitudinal patterns of change in systolic blood pressure and incidence of cardiovascular disease: The atherosclerosis risk in communities study

Natalia Petruski-Ivleva, Anthony J. Viera, Daichi Shimbo, Paul Muntner, Christy L. Avery, Andrea L.C. Schneider, David Couper, Anna Kucharska-Newton

Research output: Contribution to journalArticlepeer-review

34 Scopus citations


Elevated blood pressure in midlife contributes significantly to the risk of cardiovascular disease. However, patterns of blood pressure increase may differ among individuals and may result in differential risk. Our goal was to examine the contribution of longitudinal patterns of blood pressure change to incidence of heart failure, coronary heart disease, stroke, and cardiovascular disease mortality. Latent class growth models were used to identify patterns of change in blood pressure across 4 clinical examinations (1987-1998) among 9845 Atherosclerosis Risk in Communities (ARIC) cohort participants (mean age, 53.7 [SD 5.7] years). Patterns of change in systolic blood pressure included slowly and steeply increasing, a decreasing and a sustained elevated blood pressure. Changes in diastolic and mid-blood pressure (systolic+diastolic) were less pronounced. The association of blood pressure pattern group membership with incidence of clinical outcomes was examined in follow-up from the fourth clinical examination (1996-1998) to December 31, 2011, using Poisson regression models adjusted for demographic and metabolic characteristics, and hypertension medication use. A gradient of rates of all events was observed across the identified patterns. Associations were attenuated after adjustment for covariates. Cumulative systolic blood pressure load, rather than the temporal pattern of change in systolic blood pressure itself, plays a role in determining the risk of cardiovascular disease, in particular, of heart failure and cardiovascular disease mortality, independent of blood pressure level measured at one point in time.

Original languageEnglish
Pages (from-to)1150-1156
Number of pages7
Issue number6
StatePublished - Jun 1 2016

Bibliographical note

Funding Information:
The Atherosclerosis Risk in Communities (ARIC) study is performed as a collaborative study supported by National Heart, Lung, and Blood Institute contracts (HHSN268201100005C, HHSN268201100006C, HHSN268201100007C, HHSN268201100008C, HHSN268201100009C, HHSN268201100010C, HHSN268201100011C, and HHSN268 201100012C). We thank the staff and participants of the ARIC study for their important contributions. This study was supported by National Institutes of Health/National Heart, Lung, and Blood Institute.

Publisher Copyright:
© 2016 American Heart Association, Inc.


  • blood pressure
  • cardiovascular diseases
  • coronary disease
  • heart failure
  • hypertension
  • stroke

ASJC Scopus subject areas

  • Internal Medicine


Dive into the research topics of 'Longitudinal patterns of change in systolic blood pressure and incidence of cardiovascular disease: The atherosclerosis risk in communities study'. Together they form a unique fingerprint.

Cite this