Cited by 1,015Blood Pressure and Hypertension StudiesSodium Intake and HealthCardiovascular Health and Disease Prevention

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Blood Pressure, Systolic and Diastolic, and Cardiovascular Risks: US Population Data

Stamler, Jeremiah·1993·Archives of Internal Medicine

DOI 10.1001/archinte.1993.00410050036006

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Abstract

The National High Blood Pressure Education Program (NHBPEP) was launched 20 years ago based on data from population studies and clinical trials that showed high blood pressure (HBP) was a major unsolved—but soluble—mass public health problem. The present review summarizes recent data from US prospective population studies on blood pressure—systolic (SBP), diastolic (DBP)—and cardiovascular risk. The outcome variables include blood pressure-related risks, primarily incidence and mortality from coronary heart disease, stroke, other and all cardiovascular diseases (CVD); also cardiac abnormalites (roentgenographic, electrocardiographic, echocardiographic); also, all-cause mortality and life expectancy. Data accrued during the past 20 years confirm that SBP and DBP have continuous, graded, strong, independent, etiologically significant relationships to the outcome variables. These relationships are documented for young, middle-aged, and older men and for middle-aged and older women of varying socioeconomic backgrounds and ethnicity. Among persons aged 35 years or more, most have SBP/DBP above optimal (<120/<80 mm Hg); hence, they are at increased CVD risk, ie, the blood pressure problem involves most of the population, not only the substantial minority with clinical HBP. For middleaged and older persons, SBP relates even more strongly to risk than DBP; at every DBP level, higher SBP results in greater CVD risk and curtailment of life expectancy. A great potential exists for improved health and increased longevity through control of the blood pressure problem. Its realization requires a strategy combining populationwide and high-risk approaches, the former to prevent rise of blood pressure with age and to achieve primary prevention of HBP by nutritional-hygienic means; the latter to enhance detection, treatment, and control of HBP. The newly expanded goals of the NHBPEP, aimed at implementing this broader strategy for the solution of the blood pressure problem, merit active support from physicians and all health professionals. (Arch Intern Med. 1993;153:598-615)

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“Observational studies have established a positive and graded relationbetweenBP levelsandCVDrisk.(1,2)Evenslightlyelevated BP levels (>120/80 mm Hg) are associated with higher risk of BP progression toward hypertension(23) andwith greater hazards for incident CVD events prospectively compared with participants with BP…”
Metabolic Changes Associated With the Use of Integrase Strand Transfer Inhibitors Among Virally Controlled Women
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Background
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BackgroundInfluential
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“In nonuremic individuals hypertension is the major cause of CV morbidity and mortality (112, 113).”
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Self-citation
A double-blind randomized crossover trial of two loop diuretics in chronic kidney disease
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Background

Authors: Stamler, J.
Corresponding author: Stamler, Jeremiah
Venue: Archives of Internal Medicine
Publisher: American Medical Association (AMA)
Published: 1993-03-08
Volume: 153
Issue: 5
Pages: 598
ISSN: 0003-9926 (ISSN-L)
DOI: 10.1001/archinte.1993.00410050036006
OpenAlex: W2608915729
Cited by: 1,015
References: 0
Citations by year: 2026: 8 · 2025: 7 · 2024: 17 · 2023: 24 · 2022: 22 · 2021: 27 · 2020: 26 · 2019: 31 · 2018: 39 · 2017: 24 · 2016: 21 · 2015: 36 · 2014: 30 · 2013: 31 · 2012: 43
FWCI: 12.39
Type: journal article
Language: en
Open access: closed
Locations: Archives of Internal Medicine (publishedVersion)
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
Health Sciences › Nursing › Nutrition and Dietetics › Sodium Intake and Health
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
Keywords: blood pressure, systolic blood pressure, diastolic blood pressure, cardiovascular risk, hypertension, coronary artery disease, stroke, cardiovascular mortality, life expectancy, primary prevention, hypertension control, National High Blood Pressure Education Program, population-based prevention

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Blood Pressure, Systolic and Diastolic, and Cardiovascular Risks: US Population Data

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