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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Self-citation
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Greenlund, K. J., Daviglus, M. L., & Croft, J. B. (2009) · Journal of Hypertension · doi:10.1097/hjh.0b013e32832926fb · Cited by 34
Identifying Individuals at Risk for Cardiovascular Events Across the Spectrum of Blood Pressure Levels
Karmali, K. N., Ning, H., Goff, D. C., & Lloyd‐Jones, D. M. (2015) · Journal of the American Heart Association · doi:10.1161/jaha.115.002126 · Cited by 35
Emotional and instrumental support during childhood and biological dysregulation in mid-life
Slopen, N., Chen, Y., Priest, N., Albert, M., & Williams, D. R. (2015) · Preventive Medicine · doi:10.1016/j.ypmed.2015.12.003 · Cited by 35
“Furthermore, the selected indicators/systems have been shown to be associated with chronic disease (Cooney et al., 2009, 2010; Danesh et al., 1998; de Koning et al., 2007; Muntner et al., 2005; Prospective Studies Collaboration, 2007; Stamler et al., 1993).”
Elevated Blood Pressure in the Emergency Department
Oras, P., Häbel, H., Skoglund, P. H., & Svensson, P. (2019) · Hypertension · doi:10.1161/hypertensionaha.119.14002 · Cited by 35
Arterial blood pressure responses to short-term exposure to fine and ultrafine particles from indoor sources – A randomized sham-controlled exposure study of healthy volunteers
Soppa, V., Schins, R. P. F., Hennig, F., Nieuwenhuijsen, M. J., Hellack, B., Quaß, U., Kaminski, H., Sasse, B., Shinnawi, S., Kuhlbusch, T. A. J., et al. (2017) · Environmental Research · doi:10.1016/j.envres.2017.06.006 · Cited by 36
The Effects of Amlodipine Compared to Losartan in Patients With Mild to Moderately Severe Hypertension
Phillips, R. A., Kloner, R. A., Grimm, R. H., & Weinberger, M. H. (2003) · Journal of Clinical Hypertension · doi:10.1111/j.1524-6175.2003.01416.x · Cited by 36
A New Classification Scheme for Hypertension Based on Relative and Absolute Risk With Implications for Treatment and Reimbursement
Black, H. R., & Yi, J.-Y. (1996) · Hypertension · doi:10.1161/01.hyp.28.5.719 · Cited by 34
Assessing Cardiovascular Risk
Schillaci, G., Pirro, M., & Mannarino, E. (2009) · Circulation · doi:10.1161/circulationaha.108.827931 · Cited by 34
Eating frequency is inversely associated with blood pressure and hypertension in Korean adults: analysis of the Third Korean National Health and Nutrition Examination Survey
Kim, S., Park, G.-H., Yang, J. H., Chun, S. H., Yoon, H., & Park, M.-S. (2014) · European Journal of Clinical Nutrition · doi:10.1038/ejcn.2014.9 · Cited by 32
The moderating effect of perceived organizational support on the relationships between organizational justice and objective measures of cardiovascular health
Rineer, J. R., Truxillo, D. M., Bodner, T., Hammer, L. B., & Kraner, M. (2017) · European Journal of Work and Organizational Psychology · doi:10.1080/1359432x.2016.1277207 · Cited by 33
Pharmacoeconomic Burden of Undertreating Hypertension
Esposti, L. D., & Valpiani, G. (2004) · PharmacoEconomics · doi:10.2165/00019053-200422140-00002 · Cited by 33
Absence of Age-Related Increase in Systolic Blood Pressure in Ambulatory Patients with HIV Infection
MATTANA, J., Siegal, F. P., Sankaran, R. T., & Singhal, P. C. (1999) · The American Journal of the Medical Sciences · doi:10.1097/00000441-199904000-00004 · Cited by 34
Blood pressure variability, dementia, and role of antihypertensive medications in older adults
Mahinrad, S., Bennett, D. A., Sorond, F. A., & Gorelick, P. B. (2023) · Alzheimer's & Dementia · doi:10.1002/alz.12935 · Cited by 32
The Effect of Age on Risk Factors for Ischemic Heart Disease
TATE, R. B., Manfreda, J., & Cuddy, T. E. (1998) · Annals of Epidemiology · doi:10.1016/s1047-2797(98)00011-8 · Cited by 32
Trends in hypertension care in eastern and south-western Finland during 1982–2002
Kastarinen, M. J., Antikaínen, R., Laatikainen, T. K., et al. (2006) · Journal of Hypertension · doi:10.1097/01.hjh.0000222751.90443.0a · Cited by 32
Assessment of drug-induced increases in blood pressure during drug development: Report from the Cardiac Safety Research Consortium
Sager, P. T., Heilbraun, J., Turner, J. R., Gintant, G. A., Geiger, M. J., Kowey, P. R., Mansoor, G. A., Mendzelevski, B., Michelson, E. L., Stockbridge, N., et al. (2013) · American Heart Journal · doi:10.1016/j.ahj.2013.01.002 · Cited by 32
“There is powerful epidemiologic evidence showing that as BP increases in a population, the risk of cardiovascular (CV) events increases.(10,11) In addition, multiple placebo-controlled clinical trials over the past 4”
Background
Selective Genotyping Reveals Association Between the Epithelial Sodium Channel γ-Subunit and Systolic Blood Pressure
Büsst, C., Scurrah, K. J., Ellis, J. A., & Harrap, S. B. (2007) · Hypertension · doi:10.1161/hypertensionaha.107.089128 · Cited by 31
MicroRNAs are associated with blood-pressure effects of exposure to particulate matter: Results from a mediated moderation analysis
Motta, V., Favero, C., Dioni, L., Iodice, S., Battaglia, C., Angelici, L., Vigna, L., Pesatori, A. C., & Bollati, V. (2016) · Environmental Research · doi:10.1016/j.envres.2016.01.010 · Cited by 33
Obesity, Visceral Fat, and Hypertension-Related Complications
Haberka, M., Stolarz‐Skrzypek, K., Biedroń, M., Szóstak-Janiak, K., Partyka, M., Olszanecka‐Glinianowicz, M., & Gąsior, Z. (2018) · Metabolic Syndrome and Related Disorders · doi:10.1089/met.2018.0062 · Cited by 31
The effect of caloric restriction on blood pressure and cardiovascular function: A systematic review and meta-analysis of randomized controlled trials
Kirkham, A. A., Beka, V., & Prado, C. M. M. (2020) · Clinical Nutrition · doi:10.1016/j.clnu.2020.06.029 · Cited by 31
Hypertension and the Role of Dietary Fiber
Nepali, P., Suresh, S., Pikale, G., Jhaveri, S., Avanthika, C., Bansal, M., Islam, R., & Chanpura, A. (2022) · Current Problems in Cardiology · doi:10.1016/j.cpcardiol.2022.101203 · Cited by 38
Perioperative control of hypertension: When will it adversely affect perioperative outcome?
Sear, J. W. (2008) · Current Hypertension Reports · doi:10.1007/s11906-008-0090-2 · Cited by 31
Prehypertension and endothelial progenitor cell function
MacEneaney, O. J., DeSouza, C. A., Weil, B. R., Kushner, E. J., Guilder, G. P. V., Mestek, M. L., Greiner, J. J., & Stauffer, B. L. (2010) · Journal of Human Hypertension · doi:10.1038/jhh.2010.31 · Cited by 30
“increased risk of myocardial infarction and ischemic stroke, are attributable to elevations in systolic BP (22;23).”
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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