Published Online
on June 27, 2005

A more recent version of this article appeared on August 1, 2005

This Article Full Text (PDF) Data Supplement All Versions of this Article: 46/2/280    most recent 01.HYP.0000173433.67426.9bv1 Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Franco, O. H. Articles by de Laet, C. Search for Related Content PubMed PubMed Citation Articles by Franco, O. H. Articles by de Laet, C. Pubmed/NCBI databases Medline Plus Health Information High Blood Pressure Seniors' Health Related Collections Epidemiology Other hypertension

Submitted on March 14, 2005
Revised on April 8, 2005

Blood Pressure in Adulthood and Life Expectancy With Cardiovascular Disease in Men and Women. Life Course Analysis

Oscar H. Franco^*; Anna Peeters; Luc Bonneux; and Chris de Laet

From Erasmus MC, University Medical Center Rotterdam, Department of Public Health, The Netherlands (O.H.F., C.d.L.); the Department of Epidemiology and Preventive Medicine, Monash University Central and Eastern Clinical School, Melbourne, Australia (A.P.); Federal Knowledge Center for Health Care (KCE), Brussels, Belgium (L.B.); and Department of Epidemiology, Scientific Institute of Public Health, Brussels, Belgium (C.d.L.).

^* To whom correspondence should be addressed. E-mail: o.francoduran{at}erasmusmc.nl.

Abstract--Limited information exists about the consequences of hypertension during adulthood on residual life expectancy with cardiovascular disease. We aimed to analyze the life course of people with high blood pressure levels at age 50 in terms of total life expectancy and life expectancy with and without cardiovascular disease compared with normotensives. We constructed multistate life tables for cardiovascular disease, myocardial infarction, and stroke using data from 3128 participants of the Framingham Heart Study who had their 50th birthday while enrolled in the study. For the life table calculations, we used hazard ratios for 3 transitions (healthy to death, healthy to disease, and disease to death) by categories of blood pressure level and adjusted by age, sex, and confounders. Irrespective of sex, 50-year-old hypertensives compared with normotensives had a shorter life expectancy, a shorter life expectancy free of cardiovascular disease, myocardial infarction, and stroke, and a longer life expectancy lived with these diseases. Normotensive men (22% of men) survived 7.2 years (95% confidence interval, 5.6 to 9.0) longer without cardiovascular disease compared with hypertensives and spent 2.1 (0.9 to 3.4) fewer years of life with cardiovascular disease. Similar differences were observed in women. Compared with hypertensives, total life expectancy was 5.1 and 4.9 years longer for normotensive men and women, respectively. Increased blood pressure in adulthood is associated with large reductions in life expectancy and more years lived with cardiovascular disease. This effect is larger than estimated previously and affects both sexes similarly. Our findings underline the tremendous importance of preventing high blood pressure and its consequences in the population.

Key words: blood pressure • cardiovascular diseases

This article has been cited by other articles:

				S. S. Najjar, A. Scuteri, V. Shetty, J. G. Wright, D. C. Muller, J. L. Fleg, H. P. Spurgeon, L. Ferrucci, and E. G. Lakatta Pulse Wave Velocity Is an Independent Predictor of the Longitudinal Increase in Systolic Blood Pressure and of Incident Hypertension in the Baltimore Longitudinal Study of Aging J. Am. Coll. Cardiol., April 8, 2008; 51(14): 1377 - 1383. [Abstract] [Full Text] [PDF]

				W. Rosamond, K. Flegal, K. Furie, A. Go, K. Greenlund, N. Haase, S. M. Hailpern, M. Ho, V. Howard, B. Kissela, et al. Heart Disease and Stroke Statistics--2008 Update: A Report From the American Heart Association Statistics Committee and Stroke Statistics Subcommittee Circulation, January 29, 2008; 117(4): e25 - e146. [Full Text] [PDF]

				N. I. Parikh, M. J. Pencina, T. J. Wang, E. J. Benjamin, K. J. Lanier, D. Levy, R. B. D'Agostino Sr, W. B. Kannel, and R. S. Vasan A Risk Score for Predicting Near-Term Incidence of Hypertension: The Framingham Heart Study Ann Intern Med, January 15, 2008; 148(2): 102 - 110. [Abstract] [Full Text] [PDF]

				A. Jacobson, C. Yan, Q. Gao, T. Rincon-Skinner, A. Rivera, J. Edwards, A. Huang, G. Kaley, and D. Sun Aging enhances pressure-induced arterial superoxide formation Am J Physiol Heart Circ Physiol, September 1, 2007; 293(3): H1344 - H1350. [Abstract] [Full Text] [PDF]

				O. H. Franco, E. W. Steyerberg, F. B. Hu, J. Mackenbach, and W. Nusselder Associations of Diabetes Mellitus With Total Life Expectancy and Life Expectancy With and Without Cardiovascular Disease Arch Intern Med, June 11, 2007; 167(11): 1145 - 1151. [Abstract] [Full Text] [PDF]

				W. Rosamond, K. Flegal, G. Friday, K. Furie, A. Go, K. Greenlund, N. Haase, M. Ho, V. Howard, B. Kissela, et al. Heart Disease and Stroke Statistics--2007 Update: A Report From the American Heart Association Statistics Committee and Stroke Statistics Subcommittee Circulation, February 6, 2007; 115(5): e69 - e171. [Full Text] [PDF]

				H. Schunkert Pharmacotherapy for Prehypertension -- Mission Accomplished? N. Engl. J. Med., April 20, 2006; 354(16): 1742 - 1744. [Full Text] [PDF]

				Minerva BMJ, September 3, 2005; 331(7515): 524 - 524. [Full Text] [PDF]

				A. Benetos Does Blood Pressure Control Contribute to a More Successful Aging? Hypertension, August 1, 2005; 46(2): 261 - 262. [Full Text] [PDF]