{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T18:11:19Z","timestamp":1792433479808,"version":"4.5.0"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"13","license":[{"start":{"date-parts":[[2020,4,11]],"date-time":"2020-04-11T00:00:00Z","timestamp":1586563200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"},{"start":{"date-parts":[[2020,4,11]],"date-time":"2020-04-11T00:00:00Z","timestamp":1586563200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","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"}]},{"DOI":"10.13039\/100007241","name":"Kaiser Foundation Research Institute","doi-asserted-by":"publisher","award":["1R01HL136685"],"award-info":[{"award-number":["1R01HL136685"]}],"id":[{"id":"10.13039\/100007241","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"NHLBI","doi-asserted-by":"publisher","award":["1R01AG059729"],"award-info":[{"award-number":["1R01AG059729"]}],"id":[{"id":"10.13039\/100000050","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"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,10,25]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Cumulative blood pressure (BP) is a measure that incorporates the severity and duration of BP exposure. The prognostic significance of cumulative BP in young adults for cardiovascular diseases (CVDs) in comparison to BP severity alone is, however, unclear.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>We investigated 3667 Coronary Artery Risk Development in Young Adults participants who attended six visits over 15 years (year-0 (1985\u20131986), year-2, year-5, year-7, year-l0, and year-15 exams). Cumulative BP was calculated as the area under the curve (mmHg\u2009\u00d7\u2009years) from year 0 through year 15. Cox models assessed the association between cumulative BP (year 0 through year 15), current BP (year 15), and BP change (year 0 and year 15) and CVD outcomes. Mean (standard deviation) age at year 15 was 40.2 (3.6) years, 44.1% were men, and 44.1% were African-American. Over a median follow-up of 16 years, there were 47 heart failure (HF), 103 coronary heart disease (CHD), 71 stroke, and 191 CVD events. Cumulative systolic BP (SBP) was associated with HF (hazard ratio (HR)\u2009=\u20092.14 (1.58\u20132.90)), CHD (HR\u2009=\u20091.49 (1.19\u20131.87)), stroke (HR\u2009=\u20091.81 (1.38\u20132.37)), and CVD (HR\u2009=\u20091.73 (1.47\u20132.05)). For CVD, the C-statistic for SBP (year 15) was 0.69 (0.65\u20130.73) and change in C-statistic with the inclusion of SBP change and cumulative SBP was 0.60 (0.56\u20130.65) and 0.72 (0.69\u20130.76), respectively. For CVD, using year-15 SBP as a reference, the net reclassification index (NRI) for cumulative SBP was 0.40 (p\u2009&amp;lt;\u20090.0001) and the NRI for SBP change was 0.22 (p\u2009=\u20090.001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Cumulative BP in young adults was associated with the subsequent risk of HF, CHD, stroke, and CVD. Cumulative BP provided incremental prognostic value and improved risk reclassification for CVD, when compared to single BP assessments or changes in BP.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1177\/2047487320915342","type":"journal-article","created":{"date-parts":[[2020,4,11]],"date-time":"2020-04-11T06:21:27Z","timestamp":1586586087000},"page":"1445-1451","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":72,"title":["Long-term cumulative blood pressure in young adults and incident heart failure, coronary heart disease, stroke, and cardiovascular disease: The CARDIA study"],"prefix":"10.1093","volume":"28","author":[{"given":"Chike C","family":"Nwabuo","sequence":"first","affiliation":[{"name":"Johns Hopkins University, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Duke","family":"Appiah","sequence":"additional","affiliation":[{"name":"Department of Public Health, Texas Tech 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USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Venkatesh L","family":"Murthy","sequence":"additional","affiliation":[{"name":"University of Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norrina B","family":"Allen","sequence":"additional","affiliation":[{"name":"Northwestern University Feinberg School of Medicine, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Sidney","sequence":"additional","affiliation":[{"name":"Kaiser Permanente Northern California, Division of Research, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Muntner","sequence":"additional","affiliation":[{"name":"University of Alabama at Birmingham, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cora E","family":"Lewis","sequence":"additional","affiliation":[{"name":"University of Alabama at Birmingham, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donald M","family":"Lloyd-Jones","sequence":"additional","affiliation":[{"name":"Northwestern University Feinberg School of Medicine, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pamela J","family":"Schreiner","sequence":"additional","affiliation":[{"name":"University of Minnesota School of Public Health, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel S","family":"Gidding","sequence":"additional","affiliation":[{"name":"Nemours Cardiac Center, Alfred I duPont Hospital for Children, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo\u00e3o A C","family":"Lima","sequence":"additional","affiliation":[{"name":"Johns Hopkins University, 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