Positional change in blood pressure and 8-year risk of hypertension: The CARDIA study

Randal J. Thomas, Kiang Liu, David R. Jacobs, Diane E. Bild, Catarina I. Kiefe, Stephen B. Hulley

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72 Scopus citations


Objective: To assess the relationship between positional blood pressure change and 8-year incidence of hypertension in a biracial cohort of young adults. Subjects and Methods: Participants from the Coronary Artery Risk Development in Young Adults (CARDIA) study with complete data from year 2 (1987-1988), year 5 (1990-1991), year 7 (1992-1993), and year 10 (1995-1996) examinations were included (N=2781). Participants were classified into 3 groups based on their year 2 systolic blood pressure response to standing: drop, a decrease in systolic blood pressure of more than 5 mm Hg; same, a change of between -5 and +5 mm Hg; and rise, more than 5-mm Hg increase. Results: The number of participants in each group was as follows: drop, 741; same, 1590; and rise, 450. The 8-year incidence of hypertension was 8.4% in the drop group, 6.8% in the same group, and 12.4% in the rise group (P<.001). Adjusted odds ratios for developing hypertension during the follow-up period in the rise group vs the same group were as follows: in black men, 2.85 (95% confidence interval [CI], 1.43-5.69), in black women, 2.47 (95% CI, 1.19-5.11), in white men, 2.17 (95% CI, 1.00-4.73), and in white women, 4.74 (95% CI, 1.11-20.30). Conclusions: A greater than 5-mm Hg increase in blood pressure on standing identified a group of young adults at increased risk of developing hypertension within 8 years. These findings support a physiologic link between sympathetic nervous system reactivity and risk of hypertension in young adults.

Original languageEnglish (US)
Pages (from-to)951-958
Number of pages8
JournalMayo Clinic Proceedings
Issue number8
StatePublished - Aug 1 2003

Bibliographical note

Funding Information:
This work was supported by grants N01HC-48047, N01HC-48048, N01HC-48049, N01HC-48050, and N01HC-95095 from the National Heart, Lung, and Blood Institute.


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