Birth cohort evidence of population influences on blood pressure in the United States, 1887-1994

被引:48
作者
Goff, DC
Howard, G
Russell, GB
Labarthe, DR
机构
[1] Wake Forest Univ, Bowman Gray Sch Med, Dept Publ Hlth Sci, Winston Salem, NC 27157 USA
[2] Univ Texas, Sch Publ Hlth, Epidemiol Res Unit, Houston, TX USA
关键词
cohort effect; primary prevention; blood pressure; hypertension;
D O I
10.1016/S1047-2797(00)00224-6
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
PURPOSE: Mean blood pressure (BP) has declined in the U.S. for several decades. It is unknown to what extent this decline was due to treatment of persons with recognized high BP or to population-wide influences on BP. Treatment would shift only the highest values lower, whereas, population-wide influences on BP would shift the entire distribution downward. METHODS: We examined changes in the distributions of systolic and diastolic BP (SBP, DBP) across birth cohorts born between 1887 and 1975 in 52,646 individuals examined in the National Health (and Nutrition) Examination Surveys between 1960 and 1994. The BP distributions were estimated as functions of age and birth-year to examine changes between birth cohorts. We postulated that the age-adjusted 10th, 50th and 90th percentiles of SEP and DBP had decreased in more recent versus earlier birth cohorts. RESULTS: The series of birth cohorts exhibited successively lower SEP and DBP at low, middle and high percentiles. In general, the 10th percentile of SEP decreased approximately 1.19 mmHg per decade of birth-year, whereas the 50th percentile decreased 2.40 mmHg per decade, and the 90th percentile decreased 4.62 mmHg per decade. A similar pattern of results was seen for DBP. CONCLUSIONS: The entire distribution of both SEP and DBP shifted downward. The downward shifts at the 50th percentile and below unequivocally demonstrate a strong prevention effect in the U.S, population during the period 1887 through 1975. This epidemiologic analysis indicates that population-wide influences can alter favorably the distribution of BP throughout the whole population. Ann Epidemiol 2001;11:271-279. (C) 2001 Elsevier Science Inc. All rights reserved.
引用
收藏
页码:271 / 279
页数:9
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