{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T01:59:14Z","timestamp":1769047154780,"version":"3.49.0"},"reference-count":15,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2021,6,27]],"date-time":"2021-06-27T00:00:00Z","timestamp":1624752000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["R01HL139716"],"award-info":[{"award-number":["R01HL139716"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100011531","name":"University of Alabama","doi-asserted-by":"publisher","award":["HHSN268201800005I"],"award-info":[{"award-number":["HHSN268201800005I"]}],"id":[{"id":"10.13039\/100011531","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100011531","name":"University of Alabama","doi-asserted-by":"publisher","award":["HHSN268201800007I"],"award-info":[{"award-number":["HHSN268201800007I"]}],"id":[{"id":"10.13039\/100011531","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007059","name":"Northwestern University","doi-asserted-by":"publisher","award":["HHSN268201800003I"],"award-info":[{"award-number":["HHSN268201800003I"]}],"id":[{"id":"10.13039\/100007059","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007249","name":"University of Minnesota","doi-asserted-by":"publisher","award":["HHSN268201800006I"],"award-info":[{"award-number":["HHSN268201800006I"]}],"id":[{"id":"10.13039\/100007249","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007241","name":"Kaiser Foundation Research Institute","doi-asserted-by":"publisher","award":["HHSN268201800004I"],"award-info":[{"award-number":["HHSN268201800004I"]}],"id":[{"id":"10.13039\/100007241","id-type":"DOI","asserted-by":"publisher"}]},{"name":"American Heart Association for the Children\u2019s Strategically Focused Research Networks","award":["17SFRN33700101"],"award-info":[{"award-number":["17SFRN33700101"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,10,27]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>For most individuals, blood pressure (BP) is related to multiple risk factors. By utilizing the decision tree analysis technique, this study aimed to identify the best discriminative risk factors and interactions that are associated with maintaining normal BP over 30 years and to reveal segments of a population with a high probability of maintaining normal BP.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Participants from the Coronary Artery Risk Development in Young Adults study aged 18\u201330 years with normal BP level at baseline visit (Y0, 1985\u20131986) were included in this study.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 3,156 participants, 1,132 (35.9%) maintained normal BP during the follow-up period and 2,024 (64.1%) developed higher BP. Systolic BP (SBP) within the normal range, race, and body mass index (BMI) were the most discriminative factors between participants who maintained normal BP throughout midlife and those who developed higher BP. Participants with a baseline SBP level \u226492 mm Hg and White women with baseline BMI &amp;lt; 23 kg\/m2 were the two segments of the population with the highest probability for maintaining normal BP throughout midlife (69.2% and 59.9%, respectively). Among Black participants aged &amp;gt;26.5 years with BMI &amp;gt; 27 kg\/m2, only 5.4% of participants maintained normal BP throughout midlife.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>This study emphasizes the importance of early life factors to later life SBP and support efforts to maintain ideal levels of risk factors for hypertension at young ages. Whether policies to maintain lower BMI and SBP well below the clinical thresholds throughout young adulthood and middle age can reduce later age hypertension should be examined in future studies.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ajh\/hpab099","type":"journal-article","created":{"date-parts":[[2021,6,25]],"date-time":"2021-06-25T19:12:32Z","timestamp":1624648352000},"page":"1037-1041","source":"Crossref","is-referenced-by-count":13,"title":["Decision Tree-Based Classification for Maintaining Normal Blood Pressure Throughout Early Adulthood and Middle Age: Findings From the Coronary Artery Risk Development in Young Adults (CARDIA) Study"],"prefix":"10.1093","volume":"34","author":[{"given":"Orna","family":"Reges","sequence":"first","affiliation":[{"name":"Department of Preventive Medicine, Northwestern Feinberg School of Medicine , Chicago, IL , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amy E","family":"Krefman","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine, Northwestern Feinberg School of Medicine , Chicago, IL , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shakia T","family":"Hardy","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, University of Alabama at Birmingham, School of Public Health , Birmingham, AL , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuichiro","family":"Yano","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Community Health, Duke University School of Medicine , Durham, NC , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Muntner","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, University of Alabama at Birmingham, School of Public Health , Birmingham, AL , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Donald M","family":"Lloyd-Jones","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine, Northwestern Feinberg School of Medicine , Chicago, IL , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Norrina B","family":"Allen","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine, Northwestern Feinberg School of Medicine , Chicago, IL , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,6,27]]},"reference":[{"key":"2022100304081726100_CIT0001","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1161\/HYPERTENSIONAHA.116.09004","article-title":"Trends in prehypertension and hypertension risk factors in US adults: 1999\u20132012","volume":"70","author":"Booth","year":"2017","journal-title":"Hypertension"},{"key":"2022100304081726100_CIT0002","doi-asserted-by":"crossref","first-page":"1278","DOI":"10.1016\/j.jacc.2018.07.008","article-title":"Prevention and control of hypertension: JACC health promotion series","volume":"72","author":"Carey","year":"2018","journal-title":"J Am Coll Cardiol"},{"key":"2022100304081726100_CIT0003","doi-asserted-by":"crossref","first-page":"1011","DOI":"10.1001\/jamacardio.2020.1731","article-title":"Association of normal systolic blood pressure level with cardiovascular disease in the absence of risk factors","volume":"5","author":"Whelton","year":"2020","journal-title":"JAMA Cardiol"},{"key":"2022100304081726100_CIT0004","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1001\/jama.2013.285122","article-title":"Blood pressure trajectories in early adulthood and subclinical atherosclerosis in middle age","volume":"311","author":"Allen","year":"2014","journal-title":"JAMA"},{"key":"2022100304081726100_CIT0005","doi-asserted-by":"crossref","first-page":"e007988","DOI":"10.1161\/JAHA.117.007988","article-title":"Cumulative incidence of hypertension by 55 years of age in blacks and whites: the CARDIA study","volume":"7","author":"Thomas","year":"2018","journal-title":"J Am Heart Assoc"},{"key":"2022100304081726100_CIT0006","doi-asserted-by":"crossref","first-page":"3092","DOI":"10.1001\/jama.290.23.3092","article-title":"Cardiorespiratory fitness in young adulthood and the development of cardiovascular disease risk factors","volume":"290","author":"Carnethon","year":"2003","journal-title":"JAMA"},{"key":"2022100304081726100_CIT0007","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1038\/sj.jhh.1000740","article-title":"Ten-year incidence of elevated blood pressure and its predictors: the CARDIA study. 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