Higher risk of cardiovascular mortality among lean hypertensive individuals in Tecumseh, Michigan
A cohort of 2181 men and women, aged 40 to 79 years, without evidence of coronary heart disease or cancer at entry to the Tecumseh Study was evaluated. Subjects were defined as lean if their Metropolitan Life Insurance table relative weight was < 110 (n = 584) and as obese if their relative weigh...
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| Veröffentlicht in: | Circulation (New York, N.Y.) N.Y.), 1994-02, Vol.89 (2), p.703-711 |
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| container_title | Circulation (New York, N.Y.) |
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| creator | CARMAN, W. J BARRETT-CONNOR, E SOWERS, M KAY-TEE KHAW |
| description | A cohort of 2181 men and women, aged 40 to 79 years, without evidence of coronary heart disease or cancer at entry to the Tecumseh Study was evaluated.
Subjects were defined as lean if their Metropolitan Life Insurance table relative weight was < 110 (n = 584) and as obese if their relative weight was > or = 120 (n = 1024). There were 688 subjects with hypertension at study entry (systolic blood pressure > or = 160, diastolic blood pressure > or = 95, or treated). The 29-year relative risk (RR) of mortality from ischemic heart disease (IHD) or cardiovascular disease (CVD) associated with systolic blood pressure level was significant for both lean and obese subjects. Among hypertensive subjects, the RR of fatal IHD for lean versus obese hypertensive subjects was 1.87 (95% confidence interval, 1.21 to 2.88) and the RR of fatal CVD was 1.56 (95% confidence interval, 1.10 to 2.20) using a Cox proportional-hazards model to adjust for the independent effects of age and traditional CVD risk factors. The findings are consistent with other studies in men showing lean hypertensive subjects to be at greater risk of IHD or CVD mortality than obese hypertensive subjects. A similar finding is now observed in women.
Associations do not prove causality or dictate management. Nevertheless, the unexplained higher mortality in lean versus obese hypertensive subjects has now been reported with sufficient frequency to suggest that the association is real (if unexplained). Determining the reasons for this association may improve targeted prevention and treatment strategies. |
| doi_str_mv | 10.1161/01.cir.89.2.703 |
| format | Article |
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Subjects were defined as lean if their Metropolitan Life Insurance table relative weight was < 110 (n = 584) and as obese if their relative weight was > or = 120 (n = 1024). There were 688 subjects with hypertension at study entry (systolic blood pressure > or = 160, diastolic blood pressure > or = 95, or treated). The 29-year relative risk (RR) of mortality from ischemic heart disease (IHD) or cardiovascular disease (CVD) associated with systolic blood pressure level was significant for both lean and obese subjects. Among hypertensive subjects, the RR of fatal IHD for lean versus obese hypertensive subjects was 1.87 (95% confidence interval, 1.21 to 2.88) and the RR of fatal CVD was 1.56 (95% confidence interval, 1.10 to 2.20) using a Cox proportional-hazards model to adjust for the independent effects of age and traditional CVD risk factors. The findings are consistent with other studies in men showing lean hypertensive subjects to be at greater risk of IHD or CVD mortality than obese hypertensive subjects. A similar finding is now observed in women.
Associations do not prove causality or dictate management. Nevertheless, the unexplained higher mortality in lean versus obese hypertensive subjects has now been reported with sufficient frequency to suggest that the association is real (if unexplained). Determining the reasons for this association may improve targeted prevention and treatment strategies.</description><identifier>ISSN: 0009-7322</identifier><identifier>EISSN: 1524-4539</identifier><identifier>DOI: 10.1161/01.cir.89.2.703</identifier><identifier>PMID: 8313558</identifier><identifier>CODEN: CIRCAZ</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Adult ; Age Factors ; Aged ; Alcohol Drinking ; Biological and medical sciences ; Body Weight ; Cardiology. Vascular system ; Cardiovascular Diseases - etiology ; Cardiovascular Diseases - mortality ; Cohort Studies ; Coronary Disease - etiology ; Coronary Disease - mortality ; Coronary heart disease ; Female ; Heart ; Humans ; Hypertension - complications ; Longitudinal Studies ; Male ; Medical sciences ; Middle Aged ; Obesity - complications ; Proportional Hazards Models ; Risk Factors ; Sex Factors ; Smoking</subject><ispartof>Circulation (New York, N.Y.), 1994-02, Vol.89 (2), p.703-711</ispartof><rights>1994 INIST-CNRS</rights><rights>Copyright American Heart Association, Inc. Feb 1994</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c495t-fab5542f353b107df6fe388ff71904ae510fe7d992706ba8e8ec3b5a954ddd253</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>309,310,314,780,784,789,790,3687,23930,23931,25140,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=3943178$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/8313558$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>CARMAN, W. J</creatorcontrib><creatorcontrib>BARRETT-CONNOR, E</creatorcontrib><creatorcontrib>SOWERS, M</creatorcontrib><creatorcontrib>KAY-TEE KHAW</creatorcontrib><title>Higher risk of cardiovascular mortality among lean hypertensive individuals in Tecumseh, Michigan</title><title>Circulation (New York, N.Y.)</title><addtitle>Circulation</addtitle><description>A cohort of 2181 men and women, aged 40 to 79 years, without evidence of coronary heart disease or cancer at entry to the Tecumseh Study was evaluated.
Subjects were defined as lean if their Metropolitan Life Insurance table relative weight was < 110 (n = 584) and as obese if their relative weight was > or = 120 (n = 1024). There were 688 subjects with hypertension at study entry (systolic blood pressure > or = 160, diastolic blood pressure > or = 95, or treated). The 29-year relative risk (RR) of mortality from ischemic heart disease (IHD) or cardiovascular disease (CVD) associated with systolic blood pressure level was significant for both lean and obese subjects. Among hypertensive subjects, the RR of fatal IHD for lean versus obese hypertensive subjects was 1.87 (95% confidence interval, 1.21 to 2.88) and the RR of fatal CVD was 1.56 (95% confidence interval, 1.10 to 2.20) using a Cox proportional-hazards model to adjust for the independent effects of age and traditional CVD risk factors. The findings are consistent with other studies in men showing lean hypertensive subjects to be at greater risk of IHD or CVD mortality than obese hypertensive subjects. A similar finding is now observed in women.
Associations do not prove causality or dictate management. Nevertheless, the unexplained higher mortality in lean versus obese hypertensive subjects has now been reported with sufficient frequency to suggest that the association is real (if unexplained). Determining the reasons for this association may improve targeted prevention and treatment strategies.</description><subject>Adult</subject><subject>Age Factors</subject><subject>Aged</subject><subject>Alcohol Drinking</subject><subject>Biological and medical sciences</subject><subject>Body Weight</subject><subject>Cardiology. Vascular system</subject><subject>Cardiovascular Diseases - etiology</subject><subject>Cardiovascular Diseases - mortality</subject><subject>Cohort Studies</subject><subject>Coronary Disease - etiology</subject><subject>Coronary Disease - mortality</subject><subject>Coronary heart disease</subject><subject>Female</subject><subject>Heart</subject><subject>Humans</subject><subject>Hypertension - complications</subject><subject>Longitudinal Studies</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Obesity - complications</subject><subject>Proportional Hazards Models</subject><subject>Risk Factors</subject><subject>Sex Factors</subject><subject>Smoking</subject><issn>0009-7322</issn><issn>1524-4539</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1994</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkEtrGzEURkVpSR23664KopSsMhM9RiNpGUzzgJRCSddCI13ZSufhSjMG__sqxGSRla74zv24HIS-UFJT2tIrQmsXU610zWpJ-Du0ooI1VSO4fo9WhBBdSc7YR3Se81P5tlyKM3SmOOVCqBWyd3G7g4RTzH_xFLCzycfpYLNbepvwMKXZ9nE-YjtM4xb3YEe8O-4hzTDmeAAcRx8P0S-2z2XGj-CWIcPuEv-Mbhe3dvyEPoQSwufTu0Z_bn48bu6qh1-395vrh8o1WsxVsJ0QDQtc8I4S6UMbgCsVgqSaNBYEJQGk15pJ0nZWgQLHO2G1aLz3TPA1unjp3afp3wJ5NkPMDvrejjAt2ciWi4bQZ_DbG_BpWtJYbjOMlnYli5w1unqBXJpyThDMPsXBpqOhxDybN4Sazf1vo7RhppgvG19PtUs3gH_lT6pL_v2UF7m2D8mOLuZXjOuGU6n4f7gejIE</recordid><startdate>19940201</startdate><enddate>19940201</enddate><creator>CARMAN, W. J</creator><creator>BARRETT-CONNOR, E</creator><creator>SOWERS, M</creator><creator>KAY-TEE KHAW</creator><general>Lippincott Williams & Wilkins</general><general>American Heart Association, Inc</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>U9A</scope><scope>7X8</scope></search><sort><creationdate>19940201</creationdate><title>Higher risk of cardiovascular mortality among lean hypertensive individuals in Tecumseh, Michigan</title><author>CARMAN, W. J ; BARRETT-CONNOR, E ; SOWERS, M ; KAY-TEE KHAW</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c495t-fab5542f353b107df6fe388ff71904ae510fe7d992706ba8e8ec3b5a954ddd253</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1994</creationdate><topic>Adult</topic><topic>Age Factors</topic><topic>Aged</topic><topic>Alcohol Drinking</topic><topic>Biological and medical sciences</topic><topic>Body Weight</topic><topic>Cardiology. Vascular system</topic><topic>Cardiovascular Diseases - etiology</topic><topic>Cardiovascular Diseases - mortality</topic><topic>Cohort Studies</topic><topic>Coronary Disease - etiology</topic><topic>Coronary Disease - mortality</topic><topic>Coronary heart disease</topic><topic>Female</topic><topic>Heart</topic><topic>Humans</topic><topic>Hypertension - complications</topic><topic>Longitudinal Studies</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Obesity - complications</topic><topic>Proportional Hazards Models</topic><topic>Risk Factors</topic><topic>Sex Factors</topic><topic>Smoking</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>CARMAN, W. J</creatorcontrib><creatorcontrib>BARRETT-CONNOR, E</creatorcontrib><creatorcontrib>SOWERS, M</creatorcontrib><creatorcontrib>KAY-TEE KHAW</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Circulation (New York, N.Y.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>CARMAN, W. J</au><au>BARRETT-CONNOR, E</au><au>SOWERS, M</au><au>KAY-TEE KHAW</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Higher risk of cardiovascular mortality among lean hypertensive individuals in Tecumseh, Michigan</atitle><jtitle>Circulation (New York, N.Y.)</jtitle><addtitle>Circulation</addtitle><date>1994-02-01</date><risdate>1994</risdate><volume>89</volume><issue>2</issue><spage>703</spage><epage>711</epage><pages>703-711</pages><issn>0009-7322</issn><eissn>1524-4539</eissn><coden>CIRCAZ</coden><abstract>A cohort of 2181 men and women, aged 40 to 79 years, without evidence of coronary heart disease or cancer at entry to the Tecumseh Study was evaluated.
Subjects were defined as lean if their Metropolitan Life Insurance table relative weight was < 110 (n = 584) and as obese if their relative weight was > or = 120 (n = 1024). There were 688 subjects with hypertension at study entry (systolic blood pressure > or = 160, diastolic blood pressure > or = 95, or treated). The 29-year relative risk (RR) of mortality from ischemic heart disease (IHD) or cardiovascular disease (CVD) associated with systolic blood pressure level was significant for both lean and obese subjects. Among hypertensive subjects, the RR of fatal IHD for lean versus obese hypertensive subjects was 1.87 (95% confidence interval, 1.21 to 2.88) and the RR of fatal CVD was 1.56 (95% confidence interval, 1.10 to 2.20) using a Cox proportional-hazards model to adjust for the independent effects of age and traditional CVD risk factors. The findings are consistent with other studies in men showing lean hypertensive subjects to be at greater risk of IHD or CVD mortality than obese hypertensive subjects. A similar finding is now observed in women.
Associations do not prove causality or dictate management. Nevertheless, the unexplained higher mortality in lean versus obese hypertensive subjects has now been reported with sufficient frequency to suggest that the association is real (if unexplained). Determining the reasons for this association may improve targeted prevention and treatment strategies.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>8313558</pmid><doi>10.1161/01.cir.89.2.703</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; American Heart Association Journals; Journals@Ovid Complete; EZB-FREE-00999 freely available EZB journals |
| subjects | Adult Age Factors Aged Alcohol Drinking Biological and medical sciences Body Weight Cardiology. Vascular system Cardiovascular Diseases - etiology Cardiovascular Diseases - mortality Cohort Studies Coronary Disease - etiology Coronary Disease - mortality Coronary heart disease Female Heart Humans Hypertension - complications Longitudinal Studies Male Medical sciences Middle Aged Obesity - complications Proportional Hazards Models Risk Factors Sex Factors Smoking |
| title | Higher risk of cardiovascular mortality among lean hypertensive individuals in Tecumseh, Michigan |
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