{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T06:01:02Z","timestamp":1789624862362,"version":"build-2803163510"},"reference-count":33,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2024,8,22]],"date-time":"2024-08-22T00:00:00Z","timestamp":1724284800000},"content-version":"unspecified","delay-in-days":21,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100006095","name":"Helse S\u00f8r-\u00d8st RHF","doi-asserted-by":"publisher","award":["Strategic Grant 2023"],"award-info":[{"award-number":["Strategic Grant 2023"]}],"id":[{"id":"10.13039\/501100006095","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Open Heart"],"accepted":{"date-parts":[[2024,8,11]]},"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>American and European guidelines define hypertension differently and are sex agnostic. Our aim was to assess the impact of different hypertension thresholds at the age of 40 on 30-year stroke risk and to examine sex differences.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We included 2608 stroke-free individuals from the Akershus Cardiac Examination 1950 Study, a Norwegian regional study conducted in 2012\u20132015 of the 1950 birth cohort, who had previously participated in the Age 40 Program, a nationwide health examination study conducted in 1990\u20131993. We categorised participants by systolic blood pressure (SBP) at age 40 (&lt;120\u2009mm Hg (reference), 120\u2013129\u2009mm Hg, 130\u2013139\u2009mm Hg and \u2265140\u2009mm Hg) and compared stroke risk using Cox proportional hazard regressions adjusted for age, sex, smoking, cholesterol, physical activity, obesity and education. Fatal and non-fatal strokes were obtained from the Norwegian Cardiovascular Disease Registry from 1 January 2012 to 31 December 2020, in addition to self-reported strokes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The mean age was 40.1\u00b10.3 years (50.4%\u2009women) and mean SBP was 128.3\u00b113.5\u2009mm Hg (mean\u00b1SD). Stroke occurred in 115 (4.4%) individuals (32 (28%) women and 83 (72%) men) during 29.4\u00b12.9 years of follow-up. SBP between 130 and 139\u2009mm Hg was not associated with stroke (adjusted HR 1.71, 95% CI 0.87 to 3.36) while SBP \u2265140\u2009mm Hg was associated with increased stroke risk (adjusted HR 3.11, 95%\u2009CI 1.62 to 6.00). The adjusted HR of stroke was 4.32 (95% CI 1.66 to 11.26) for women and 2.66 (95% CI 1.03 to 6.89) for men, with non-significant sex interactions.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>SBP \u2265140\u2009mm Hg was significantly associated with 30-year stroke risk in both sexes. A small subgroup of women had SBP \u2265140\u2009mm Hg and systolic hypertension was a strong risk factor for stroke in these women.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Trial registration number<\/jats:title>\n                  <jats:p>\n                     <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT01555411\">NCT01555411<\/jats:ext-link>.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/openhrt-2024-002805","type":"journal-article","created":{"date-parts":[[2024,8,23]],"date-time":"2024-08-23T00:55:25Z","timestamp":1724374525000},"page":"e002805","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Systolic blood pressure at age 40 and 30-year stroke risk in men and women"],"prefix":"10.1136","volume":"11","clinical-trial-number":[{"clinical-trial-number":"nct01555411","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7695-2134","authenticated-orcid":false,"given":"Marte Meyer","family":"Walle-Hansen","sequence":"first","affiliation":[{"name":"Department of Medical Research, Vestre Viken Hospital Trust, B\u00e6rum Hospital, Drammen, Norway"},{"name":"Institute of Clinical Medicine, University of Oslo Faculty of Medicine, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guri","family":"Hagberg","sequence":"additional","affiliation":[{"name":"Institute of Clinical Medicine, University of Oslo Faculty of Medicine, Oslo, Norway"},{"name":"Stroke Unit, Department of Neurology, Oslo University Hospital, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marius","family":"Myrstad","sequence":"additional","affiliation":[{"name":"Department of Medical Research, Vestre Viken Hospital Trust, B\u00e6rum Hospital, Drammen, Norway"},{"name":"Institute of Clinical Medicine, University of Oslo Faculty of Medicine, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trygve","family":"Berge","sequence":"additional","affiliation":[{"name":"Department of Medical Research, Vestre Viken Hospital Trust, B\u00e6rum Hospital, Drammen, Norway"},{"name":"Department of Internal Medicine, Vestre Viken Hospital Trust, B\u00e6rum Hospital, Drammen, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thea","family":"Vigen","sequence":"additional","affiliation":[{"name":"Department of Neurology, Division of Medicine, Akershus University Hospital, Lorenskog, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hege","family":"Ihle-Hansen","sequence":"additional","affiliation":[{"name":"Department of Medical Research, Vestre Viken Hospital Trust, B\u00e6rum Hospital, Drammen, Norway"},{"name":"Stroke Unit, Department of Neurology, Oslo University Hospital, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bente","family":"Thommessen","sequence":"additional","affiliation":[{"name":"Department of Neurology, Division of Medicine, Akershus University Hospital, Lorenskog, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8529-4826","authenticated-orcid":false,"given":"Inger","family":"Ariansen","sequence":"additional","affiliation":[{"name":"Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magnus Nakrem","family":"Lyngbakken","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Division of Medicine, Akershus University Hospital, Lorenskog, Norway"},{"name":"K.G. Jebsen Center for Cardiac Biomarkers, Institute for Clinical Medicine, University of Oslo, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helge","family":"R\u00f8sj\u00f8","sequence":"additional","affiliation":[{"name":"K.G. Jebsen Center for Cardiac Biomarkers, Institute for Clinical Medicine, University of Oslo, Oslo, Norway"},{"name":"Akershus Clinical Research Center, Division of Research and Innovation, Akershus University Hospital, Lorenskog, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ole Morten","family":"R\u00f8nning","sequence":"additional","affiliation":[{"name":"Institute of Clinical Medicine, University of Oslo Faculty of Medicine, Oslo, Norway"},{"name":"Department of Neurology, Division of Medicine, Akershus University Hospital, Lorenskog, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arnljot","family":"Tveit","sequence":"additional","affiliation":[{"name":"Department of Medical Research, Vestre Viken Hospital Trust, B\u00e6rum Hospital, Drammen, Norway"},{"name":"Institute of Clinical Medicine, University of Oslo Faculty of Medicine, Oslo, 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The Norwegian Stroke Register; 2022."},{"key":"2025081710151743000_11.2.e002805.29","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2018-021704","article-title":"Prevalence of atrial fibrillation and cardiovascular risk factors in a 63-65 years old general population cohort: the Akershus Cardiac Examination (ACE) 1950 Study","volume":"8","author":"Berge","year":"2018","journal-title":"BMJ Open"},{"key":"2025081710151743000_11.2.e002805.30","doi-asserted-by":"crossref","DOI":"10.1111\/eci.13876","article-title":"Serial blood pressure measurements, left ventricular remodelling and cardiovascular outcomes","volume":"53","author":"Lyngbakken","year":"2023","journal-title":"Eur J Clin Invest"},{"key":"2025081710151743000_11.2.e002805.31","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.31.7.1602"},{"key":"2025081710151743000_11.2.e002805.32","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.27.9.1499"},{"key":"2025081710151743000_11.2.e002805.33","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a009387"}],"container-title":["Open Heart"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/openhrt-2024-002805","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,17]],"date-time":"2025-08-17T17:15:24Z","timestamp":1755450924000},"score":1,"resource":{"primary":{"URL":"https:\/\/openheart.bmj.com\/lookup\/doi\/10.1136\/openhrt-2024-002805"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8]]},"references-count":33,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2024,8,22]]},"published-print":{"date-parts":[[2024,8]]}},"alternative-id":["10.1136\/openhrt-2024-002805"],"URL":"https:\/\/doi.org\/10.1136\/openhrt-2024-002805","relation":{},"ISSN":["2053-3624"],"issn-type":[{"value":"2053-3624","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,8]]}}}