{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T09:20:04Z","timestamp":1780996804054,"version":"3.54.1"},"reference-count":49,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2017,8,29]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Data from before the 2000s indicate that the majority of incident cardiovascular disease (CVD) events occur among US adults with systolic and diastolic blood pressure (SBP\/DBP) \u2265140\/90 mm\u2009Hg. Over the past several decades, BP has declined and hypertension control has improved.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>We estimated the percentage of incident CVD events that occur at SBP\/DBP &lt;140\/90 mm\u2009Hg in a pooled analysis of 3 contemporary US cohorts: the REGARDS study (Reasons for Geographic and Racial Differences in Stroke), the MESA (Multi-Ethnic Study of Atherosclerosis), and the JHS (Jackson Heart Study) (n=31\u2009856; REGARDS=21\u2009208; MESA=6779; JHS=3869). Baseline study visits were conducted in 2003 to 2007 for REGARDS, 2000 to 2002 for MESA, and 2000 to 2004 for JHS. BP was measured by trained staff using standardized methods. Antihypertensive medication use was self-reported. The primary outcome was incident CVD, defined by the first occurrence of fatal or nonfatal stroke, nonfatal myocardial infarction, fatal coronary heart disease, or heart failure. Events were adjudicated in each study.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>Over a mean follow-up of 7.7 years, 2584 participants had incident CVD events. Overall, 63.0% (95% confidence interval [CI], 54.9\u221271.1) of events occurred in participants with SBP\/DBP &lt;140\/90 mm\u2009Hg; 58.4% (95% CI, 47.7\u221269.2) and 68.1% (95% CI, 60.1\u221276.0) among those taking and not taking antihypertensive medication, respectively. The majority of events occurred in participants with SBP\/DBP &lt;140\/90 mm\u2009Hg among those &lt;65 years of age (66.7%; 95% CI, 60.5\u221273.0) and \u226565 years of age (60.3%; 95% CI, 51.0\u221269.5), women (61.4%; 95% CI, 49.9\u221272.9) and men (63.8%; 95% CI, 58.4\u221269.1), and for whites (68.7%; 95% CI, 66.1\u221271.3), blacks (59.0%; 95% CI, 49.5\u221268.6), Hispanics (52.7%; 95% CI, 45.1\u221260.4), and Chinese-Americans (58.5%; 95% CI, 45.2\u221271.8). Among participants taking antihypertensive medication with SBP\/DBP &lt;140\/90 mm\u2009Hg, 76.6% (95% CI, 75.8\u221277.5) were eligible for statin treatment, but only 33.2% (95% CI, 32.1\u221234.3) were taking one, and 19.5% (95% CI, 18.5\u221220.5) met the SPRINT (Systolic Blood Pressure Intervention Trial) eligibility criteria and may benefit from a SBP target goal of 120 mm\u2009Hg.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>Although higher BP levels are associated with increased CVD risk, in the modern era, the majority of incident CVD events occur in US adults with SBP\/DBP &lt;140\/90 mm\u2009Hg. While absolute risk and cost-effectiveness should be considered, additional CVD risk-reduction measures for adults with SBP\/DBP &lt;140\/90 mm\u2009Hg at high risk for CVD may be warranted.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circulationaha.117.027362","type":"journal-article","created":{"date-parts":[[2017,6,21]],"date-time":"2017-06-21T01:00:32Z","timestamp":1498006832000},"page":"798-812","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":69,"title":["Incident Cardiovascular Disease Among Adults With Blood Pressure &lt;140\/90 mm\u2009Hg"],"prefix":"10.1161","volume":"136","author":[{"given":"Gabriel S.","family":"Tajeu","sequence":"first","affiliation":[{"name":"From Department of Health Services Administration and Policy, Temple University, Philadelphia, PA (G.S.T.); Department of Epidemiology (J.N.B., L.D.C., R.M.T., P.M.), Department of Biostatistics (G.H.), Department of Medicine, Division of Cardiovascular Disease, Vascular Biology and Hypertension Program (S.O.), Department of Medicine (M.M.S.), University of Alabama at Birmingham; Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, MD (R.F.G.); Department of Neurology..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"III","given":"John N.","family":"Booth","sequence":"additional","affiliation":[{"name":"From Department of Health Services Administration and Policy, Temple University, Philadelphia, PA (G.S.T.); Department of Epidemiology (J.N.B., L.D.C., R.M.T., P.M.), Department of Biostatistics (G.H.), Department of Medicine, Division of Cardiovascular Disease, Vascular Biology and Hypertension Program (S.O.), Department of Medicine (M.M.S.), University of Alabama at Birmingham; Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, MD (R.F.G.); Department of Neurology..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisandro D.","family":"Colantonio","sequence":"additional","affiliation":[{"name":"From Department of Health Services Administration and Policy, Temple University, Philadelphia, PA (G.S.T.); Department of Epidemiology (J.N.B., L.D.C., R.M.T., P.M.), Department of Biostatistics (G.H.), Department of Medicine, Division of Cardiovascular Disease, Vascular Biology and Hypertension Program (S.O.), Department of Medicine (M.M.S.), University of Alabama at Birmingham; Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, MD (R.F.G.); Department of Neurology..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca F.","family":"Gottesman","sequence":"additional","affiliation":[{"name":"From Department of Health Services Administration and Policy, Temple University, Philadelphia, PA (G.S.T.); Department of Epidemiology (J.N.B., L.D.C., R.M.T., P.M.), Department of Biostatistics (G.H.), Department of Medicine, Division of Cardiovascular Disease, Vascular Biology and Hypertension Program (S.O.), Department of Medicine (M.M.S.), University of Alabama at Birmingham; Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, MD (R.F.G.); Department of Neurology..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Howard","sequence":"additional","affiliation":[{"name":"From Department of Health Services Administration and Policy, Temple University, Philadelphia, PA (G.S.T.); Department of Epidemiology (J.N.B., L.D.C., R.M.T., P.M.), Department of Biostatistics (G.H.), Department of Medicine, Division of Cardiovascular Disease, Vascular Biology and Hypertension Program (S.O.), Department of Medicine (M.M.S.), University of Alabama at Birmingham; Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, MD (R.F.G.); Department of Neurology..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel T.","family":"Lackland","sequence":"additional","affiliation":[{"name":"From Department of Health Services Administration and Policy, Temple University, Philadelphia, PA (G.S.T.); Department of Epidemiology (J.N.B., L.D.C., R.M.T., P.M.), Department of Biostatistics (G.H.), Department of Medicine, Division of Cardiovascular Disease, Vascular Biology and Hypertension Program (S.O.), Department of Medicine (M.M.S.), University of Alabama at Birmingham; Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, MD (R.F.G.); Department of Neurology..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily C.","family":"O\u2019Brien","sequence":"additional","affiliation":[{"name":"From Department of Health Services Administration and Policy, Temple University, Philadelphia, PA (G.S.T.); Department of Epidemiology (J.N.B., L.D.C., R.M.T., P.M.), Department of Biostatistics (G.H.), Department of Medicine, Division of Cardiovascular Disease, Vascular Biology and Hypertension Program (S.O.), Department of Medicine (M.M.S.), University of Alabama at Birmingham; Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, MD (R.F.G.); Department of Neurology..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne","family":"Oparil","sequence":"additional","affiliation":[{"name":"From Department of Health Services Administration and Policy, Temple University, Philadelphia, PA (G.S.T.); Department of Epidemiology (J.N.B., L.D.C., R.M.T., P.M.), Department of Biostatistics (G.H.), Department of Medicine, Division of Cardiovascular Disease, Vascular Biology and Hypertension Program (S.O.), Department of Medicine (M.M.S.), University of Alabama at Birmingham; Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, MD (R.F.G.); Department of Neurology..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Ravenell","sequence":"additional","affiliation":[{"name":"From Department of Health Services Administration and Policy, Temple University, Philadelphia, PA (G.S.T.); Department of Epidemiology (J.N.B., L.D.C., R.M.T., P.M.), Department of Biostatistics (G.H.), Department of Medicine, Division of Cardiovascular Disease, Vascular Biology and Hypertension Program (S.O.), Department of Medicine (M.M.S.), University of Alabama at Birmingham; Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, MD (R.F.G.); Department of Neurology..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monika M.","family":"Safford","sequence":"additional","affiliation":[{"name":"From Department of Health Services Administration and Policy, Temple University, Philadelphia, PA (G.S.T.); Department of Epidemiology (J.N.B., L.D.C., R.M.T., P.M.), Department of Biostatistics (G.H.), Department of Medicine, Division of Cardiovascular Disease, Vascular Biology and Hypertension Program (S.O.), Department of Medicine (M.M.S.), University of Alabama at Birmingham; Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, MD (R.F.G.); Department of Neurology..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samantha R.","family":"Seals","sequence":"additional","affiliation":[{"name":"From Department of Health Services Administration and Policy, Temple University, Philadelphia, PA (G.S.T.); Department of Epidemiology (J.N.B., L.D.C., R.M.T., P.M.), Department of Biostatistics (G.H.), Department of Medicine, Division of Cardiovascular Disease, Vascular Biology and Hypertension Program (S.O.), Department of Medicine (M.M.S.), University of Alabama at Birmingham; Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, MD (R.F.G.); Department of Neurology..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daichi","family":"Shimbo","sequence":"additional","affiliation":[{"name":"From Department of Health Services Administration and Policy, Temple University, Philadelphia, PA (G.S.T.); Department of Epidemiology (J.N.B., L.D.C., R.M.T., P.M.), Department of Biostatistics (G.H.), Department of Medicine, Division of Cardiovascular Disease, Vascular Biology and Hypertension Program (S.O.), Department of Medicine (M.M.S.), University of Alabama at Birmingham; Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, MD (R.F.G.); Department of Neurology..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"Shea","sequence":"additional","affiliation":[{"name":"From Department of Health Services Administration and Policy, Temple University, Philadelphia, PA (G.S.T.); Department of Epidemiology (J.N.B., L.D.C., R.M.T., P.M.), Department of Biostatistics (G.H.), Department of Medicine, Division of Cardiovascular Disease, Vascular Biology and Hypertension Program (S.O.), Department of Medicine (M.M.S.), University of Alabama at Birmingham; Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, MD (R.F.G.); Department of Neurology..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanya M.","family":"Spruill","sequence":"additional","affiliation":[{"name":"From Department of Health Services Administration and Policy, Temple University, Philadelphia, PA (G.S.T.); Department of Epidemiology (J.N.B., L.D.C., R.M.T., P.M.), Department of Biostatistics (G.H.), Department of Medicine, Division of Cardiovascular Disease, Vascular Biology and Hypertension Program (S.O.), Department of Medicine (M.M.S.), University of Alabama at Birmingham; Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, MD (R.F.G.); Department of Neurology..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rikki M.","family":"Tanner","sequence":"additional","affiliation":[{"name":"From Department of Health Services Administration and Policy, Temple University, Philadelphia, PA (G.S.T.); Department of Epidemiology (J.N.B., L.D.C., R.M.T., P.M.), Department of Biostatistics (G.H.), Department of Medicine, Division of Cardiovascular Disease, Vascular Biology and Hypertension Program (S.O.), Department of Medicine (M.M.S.), University of Alabama at Birmingham; Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, MD (R.F.G.); Department of Neurology..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Muntner","sequence":"additional","affiliation":[{"name":"From Department of Health Services Administration and Policy, Temple University, Philadelphia, PA (G.S.T.); Department of Epidemiology (J.N.B., L.D.C., R.M.T., P.M.), Department of Biostatistics (G.H.), Department of Medicine, Division of Cardiovascular Disease, Vascular Biology and Hypertension Program (S.O.), Department of Medicine (M.M.S.), University of Alabama at Birmingham; Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, MD (R.F.G.); Department of Neurology..."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(02)11911-8"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.3949\/ccjm.60.4.273"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1997.00440420033005"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.289.19.2560"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1993.00410050036006"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.161.9.1183"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.161.12.1501"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2004.04.043"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.jhh.1002002"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.108.797936"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000152"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/WCO.0b013e32835c4f54"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.114.04012"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.HYP.25.3.305"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1511939"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000441-199903000-00002"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwf113"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1159\/000086678"},{"key":"e_1_3_3_20_2","first-page":"4","article-title":"Toward resolution of cardiovascular health disparities in African Americans: design and methods of the Jackson Heart Study.","volume":"15","author":"Taylor HA","year":"2005","unstructured":"Taylor HA, Wilson JG, Jones DW, Sarpong DF, Srinivasan A, Garrison RJ, Nelson C, Wyatt SB. Toward resolution of cardiovascular health disparities in African Americans: design and methods of the Jackson Heart Study. Ethn Dis. 2005;15(Suppl 6):4\u201317.","journal-title":"Ethn Dis"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2015.02.008"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.113.02026"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1093\/ajh\/hpt040"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.115.06904"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1093\/clinchem\/18.6.499"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000437741.48606.98"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000437738.63853.7a"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-150-9-200905050-00006"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2012.14306"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.98.21.2282"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2014.07.009"},{"key":"e_1_3_3_32_2","first-page":"S6","article-title":"Cardiovascular disease event classification in the Jackson Heart Study: methods and procedures.","volume":"15","author":"Keku E","year":"2005","unstructured":"Keku E, Rosamond W, Taylor HA, Garrison R, Wyatt SB, Richard M, Jenkins B, Reeves L, Sarpong D. Cardiovascular disease event classification in the Jackson Heart Study: methods and procedures. Ethn Dis. 2005;15(4 Suppl 6):S6\u2013S62.","journal-title":"Ethn Dis"},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2008.09.014"},{"key":"e_1_3_3_34_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.110.612937"},{"key":"e_1_3_3_35_2","doi-asserted-by":"publisher","DOI":"10.1186\/2049-3258-72-39"},{"key":"e_1_3_3_36_2","volume-title":"Systematic Reviews in Health Care: Meta-Analysis in Context","author":"Egger M","year":"2008","unstructured":"Egger M, Davey-Smith G, Altman D. Systematic Reviews in Health Care: Meta-Analysis in Context. New York: Wiley; 2008."},{"key":"e_1_3_3_37_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-3-21"},{"key":"e_1_3_3_38_2","doi-asserted-by":"publisher","DOI":"10.1002\/ajhb.22898"},{"key":"e_1_3_3_39_2","doi-asserted-by":"publisher","DOI":"10.1111\/jch.12196"},{"key":"e_1_3_3_40_2","doi-asserted-by":"publisher","DOI":"10.1097\/00004872-199816060-00004"},{"key":"e_1_3_3_41_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.09.007"},{"key":"e_1_3_3_42_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.19043"},{"key":"e_1_3_3_43_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.115.009128"},{"key":"e_1_3_3_44_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.115.002275"},{"key":"e_1_3_3_45_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1600176"},{"key":"e_1_3_3_46_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.6822"},{"key":"e_1_3_3_47_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2016.3517"},{"key":"e_1_3_3_48_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0895-7061(01)02324-X"},{"key":"e_1_3_3_49_2","first-page":"426","article-title":"Comparisons of ambulatory blood pressure monitoring and repeated office measurements in primary care.","volume":"45","author":"Pearce KA","year":"1997","unstructured":"Pearce KA, Evans GW, Summerson J, Rao JS. Comparisons of ambulatory blood pressure monitoring and repeated office measurements in primary care. J Fam Pract. 1997;45:426\u2013433.","journal-title":"J Fam Pract"},{"key":"e_1_3_3_50_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.285122"}],"container-title":["Circulation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCULATIONAHA.117.027362","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,6]],"date-time":"2025-02-06T08:23:32Z","timestamp":1738830212000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCULATIONAHA.117.027362"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,8,29]]},"references-count":49,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2017,8,29]]}},"alternative-id":["10.1161\/CIRCULATIONAHA.117.027362"],"URL":"https:\/\/doi.org\/10.1161\/circulationaha.117.027362","relation":{},"ISSN":["0009-7322","1524-4539"],"issn-type":[{"value":"0009-7322","type":"print"},{"value":"1524-4539","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,8,29]]},"assertion":[{"value":"2017-01-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-06-05","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-06-20","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}