Maintaining Normal Blood Pressure Across the Life Course: The JHS

Shakia T. Hardy*, Swati Sakhuja, Byron C. Jaeger, Suzanne Oparil, Oluwasegun P. Akinyelure, Tanya M. Spruill, Jolaade Kalinowski, Mark Butler, D. Edmund Anstey, Tali Elfassy, Gabriel S. Tajeu, Norrina B. Allen, Orna Reges, Mario Sims, Daichi Shimbo, Paul Muntner

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

10 Scopus citations

Abstract

Although mean blood pressure (BP) increases with age, there may be a subset of individuals whose BP does not increase with age. Characterizing the population that maintains normal BP could inform hypertension prevention efforts. We determined the proportion of Jackson Heart Study participants that maintained normal BP at 3 visits over a median of 8 years. Normal BP was defined as systolic BP <120 mm Hg and diastolic BP <80 mm Hg without antihypertensive medication. We identified lifestyle and psychosocial factors associated with maintaining normal BP and calculated the incidence rate for cardiovascular disease (CVD). Overall, 757 of 3432 participants (22.1%) had normal BP at baseline, and 262 of these participants (34.6%) maintained normal BP. Among participants with normal BP at baseline, normal body mass index (risk ratio [RR] 1.37 [95% CI, 1.08-1.75]), ideal physical activity (RR, 1.28 [95% CI, 0.99-1.65]), and never smoking (RR, 1.48 [95% CI, 0.99-2.20]) at baseline were associated with maintaining normal BP. Maintaining normal body mass index (RR, 1.42 [95% CI, 1.10-1.84]) and ideal physical activity (RR, 1.51 [95% CI, 1.18-1.94]) at all study visits were associated with maintaining normal BP. The cardiovascular disease incidence rate was 4.5, 6.3, and 16.4 per 1000 person-years among participants who maintained normal BP, had normal BP at baseline but did not maintain normal BP, and had elevated BP or hypertension at baseline, respectively, over 5.9 years of follow-up. These data suggest that maintaining normal body mass index and ideal physical activity are potential approaches for African American adults to maintain normal BP.

Original languageEnglish (US)
Pages (from-to)1490-1499
Number of pages10
JournalHypertension
Volume77
Issue number5
DOIs
StatePublished - May 1 2021

Funding

S.T. Hardy, P. Muntner, and D. Shimbo receive support through R01HL139716 from the National Heart, Lung, and Blood Institute (NHLBI). P. Muntner and D. Shimbo also receive research support through R01HL117323 from the NHLBI. D. Shimbo receives support through K24-HL125704 from the NHL-BI. B.C. Jaeger receives support through R01HL144773 from the NHLBI and 15SFRN2390002 from the American Heart Association. D.E. Anstey receives support through R01HL137818 from the NHLBI. G.S. Tajeu receives research support through R01DK108628-05S1 from the National Institute of Diabetes and Digestive and Kidney Diseases and K01HL151974 from the NHLBI. T. Elfassy receives research support through K01MD014158 from the National Institute on Minority Health and Health Disparities (NIMHD). O. Reges thanks the American Heart Association for the Children’s Strategically Focused Research Networks (SFRN) postdoctoral fellowship (grant 17SFRN33700101), and the Israel Scholarship Education Foundation for their support. The JHS (Jackson Heart Study) is supported and conducted in collaboration with Jackson State University (HHSN268201800013I), Tougaloo College (HHSN268201800014I), the Mississippi State Department of Health (HHSN268201800015I), and the University of Mississippi Medical Center (HHSN268201800010I, HHSN268201800011I, and HHSN268201800012I) contracts from the National Heart, Lung, and Blood Institute (NHLBI) and the National Institute on Minority Health and Health Disparities (NIMHD). The authors also wish to thank the staffs and participants of the JHS.

Keywords

  • Blood pressure
  • Body mass index
  • Cardiovascular disease
  • Physical activity
  • Risk factor

ASJC Scopus subject areas

  • Internal Medicine

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