{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T12:04:45Z","timestamp":1791374685482,"version":"4.3.1"},"reference-count":21,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2017,3,10]],"date-time":"2017-03-10T00:00:00Z","timestamp":1489104000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["1R01AG046206"],"award-info":[{"award-number":["1R01AG046206"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000065","name":"National Institute of Neurological Disorders and Stroke","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000065","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>BACKGROUND<\/jats:title>\n                  <jats:p>Common blood pressure (BP) trajectories are not well established in elderly persons, and their association with clinical outcomes is uncertain.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>We used hierarchical cluster analysis to identify discrete BP trajectories among 4,067 participants in the Cardiovascular Health Study using repeated BP measures from years 0 to 7. We then evaluated associations of each BP trajectory cluster with all-cause mortality, incident cardiovascular disease (CVD, defined as stroke or myocardial infarction) (N = 2,837), and incident congestive heart failure (HF) (N = 3,633) using Cox proportional hazard models.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Median age was 77 years at year 7. Over a median 9.3 years of follow-up, there were 2,475 deaths, 659 CVD events, and 1,049 HF events. The cluster analysis identified 3 distinct trajectory groups. Participants in cluster 1 (N = 1,838) had increases in both systolic (SBP) and diastolic (DBP) BPs, whereas persons in cluster 2 (N = 1,109) had little change in SBP but declines in DBP. Persons in cluster 3 (N = 1,120) experienced declines in both SBP and DBP. After multivariable adjustment, clusters 2 and 3 were associated with increased mortality risk relative to cluster 1 (hazard ratio = 1.21, 95% confidence interval: 1.06\u20131.37 and hazard ratio = 1.20, 95% confidence interval: 1.05\u20131.36, respectively). Compared to cluster 1, cluster 3 had higher rates of incident CVD but associations were not statistically significant in demographic-adjusted models (hazard ratio = 1.16, 95% confidence interval: 0.96\u20131.39). Findings were similar when stratified by use of antihypertensive therapy.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Among community-dwelling elders, distinct BP trajectories were identified by integrating both SBP and DBP. These clusters were found to have differential associations with outcomes.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ajh\/hpx028","type":"journal-article","created":{"date-parts":[[2017,2,15]],"date-time":"2017-02-15T08:56:05Z","timestamp":1487148965000},"page":"587-593","source":"Crossref","is-referenced-by-count":33,"title":["Association of Blood Pressure Trajectory With Mortality, Incident Cardiovascular Disease, and Heart Failure in the Cardiovascular Health Study"],"prefix":"10.1093","volume":"30","author":[{"given":"Christopher C.","family":"Smitson","sequence":"first","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Medicine, University of California 1 , San Diego, California , USA ;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Scherzer","sequence":"additional","affiliation":[{"name":"Kidney Health Research Collaborative, Division of Nephrology, Department of Medicine, University of California 2 , San Francisco, California , USA ;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael G.","family":"Shlipak","sequence":"additional","affiliation":[{"name":"Kidney Health Research Collaborative, Division of Nephrology, Department of Medicine, University of California 2 , San Francisco, California , USA ;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce M.","family":"Psaty","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Washington 3 , Seattle, Washington , USA ;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne B.","family":"Newman","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, University of Pittsburgh Graduate School of Public Health 4 , Pittsburgh, Pennsylvania , USA ;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark J.","family":"Sarnak","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Tufts University School of Medicine 5 , Boston, Massachusetts , USA ;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle C.","family":"Odden","sequence":"additional","affiliation":[{"name":"College of Public Health and Human Sciences, Oregon State University 6 , Corvallis, Oregon , USA ."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen A.","family":"Peralta","sequence":"additional","affiliation":[{"name":"Kidney Health Research Collaborative, Division of Nephrology, Department of Medicine, University of California 2 , San Francisco, California , USA ;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2017,3,10]]},"reference":[{"key":"2022112111212302300_CIT0001","doi-asserted-by":"crossref","first-page":"1183","DOI":"10.1001\/archinte.161.9.1183","article-title":"Association between blood pressure level and the risk of myocardial infarction, stroke, and total mortality: the cardiovascular health study","volume":"161","author":"Psaty","year":"2001","journal-title":"Arch Intern Med"},{"key":"2022112111212302300_CIT0002","doi-asserted-by":"crossref","first-page":"1304","DOI":"10.1136\/hrt.2011.225482","article-title":"Systolic blood pressure and incident heart failure in the elderly. 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