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Katic L, Choi J, Diaz Saravia S, Silverman A, Nagourney A, Torelli V, Gupta S, Glavan M, Gulati A, Khurana S, Tsyvkin E. The Interplay Between Cardiovascular Disease and Lung Cancer. Cureus 2024; 16:e62953. [PMID: 39044884 PMCID: PMC11265258 DOI: 10.7759/cureus.62953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/23/2024] [Indexed: 07/25/2024] Open
Abstract
Cardiovascular disease (CVD) and lung cancer are among the leading causes of mortality worldwide, with a significant interplay that complicates patient management and treatment outcomes. This review explores the complex relationship between various forms of CVD - such as coronary artery disease, heart failure (HF), arrhythmias, and valvular heart disease - and lung cancer. Shared risk factors, including smoking, aging, and chronic inflammation, contribute to the co-occurrence of these conditions. Additionally, treatments for lung cancer, particularly chemotherapy and radiation therapy, can exacerbate CVD, necessitating a multidisciplinary approach to patient care. We delve into specific CVD-related impacts on lung cancer prognosis and vice versa, examining mechanisms, clinical outcomes, and management strategies. Our findings highlight the need for integrated care involving oncologists, cardiologists, and other healthcare providers to optimize treatment plans and improve patient outcomes. Emphasizing comprehensive cardiovascular risk management in lung cancer patients, we advocate for further research to deepen our understanding and develop novel therapeutic approaches, ultimately enhancing the quality of life and survival rates in patients suffering from both CVD and lung cancer.
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Affiliation(s)
- Luka Katic
- Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, USA
| | - James Choi
- Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Sara Diaz Saravia
- Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, USA
| | | | | | - Vincent Torelli
- Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Soumya Gupta
- Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, USA
| | | | - Amit Gulati
- Cardiology, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Sakshi Khurana
- Radiology, New York Presbyterian-Columbia University Irving Medical Center, New York, USA
| | - Elina Tsyvkin
- Center for Hematologic Malignancies, Memorial Sloan Kettering Cancer Center, New York, USA
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Ramezankhani A, Azizi F, Hadaegh F. Sex-specific clustering of metabolic risk factors and cancer risk: a longitudinal study in Iran. Biol Sex Differ 2020; 11:21. [PMID: 32334634 PMCID: PMC7183600 DOI: 10.1186/s13293-020-00296-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 04/06/2020] [Indexed: 02/07/2023] Open
Abstract
Background Cancer is a major cause of death in low- and middle-income countries. A large number of studies have shown that some of the metabolic risk factors (MRFs) tend to cluster in individuals. We examined the synergistic effects of multiple MRFs and cancer risk among Iranian adults. Methods Among 8593 (3929 men) participants aged ≥ 30 years, the self-organizing map (SOM) was applied to clustering of four MRFs including high fasting plasma glucose (HFPG), high total cholesterol (HTC), high systolic blood pressure (HSBP), and high body mass index (HBMI). The Cox proportional hazards model was used to investigate the association between clusters with cancer incidence during a median of 14.0 years of follow-up. Results During the study period, 265 new cases of cancer were identified among participants at risk. The incidence density rate was 2.5 per 1000 person years in total population. About 32 and 40% of men and women, respectively, had three or four MRFs. We identified seven clusters of MRFs in both men and women. In both genders, MRFs were clustered in those with older age. Further, inverse associations were found between current smoking in men, and education level and passive smoking in women and clustering of MRFs. In men, a cluster with 100% HSBP and HBMI had the highest risk for overall cancer. While, among women, a cluster with 100% HFPG and 93% HBMI yielded the highest risk for cancer. The risk was decreased when HBMI accompanied by HTC. Conclusions Clustering patterns may reflect underlying link between MRFs and cancer and could potentially facilitate tailored health promotion interventions.
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Affiliation(s)
- Azra Ramezankhani
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Yemen Street, Shahid Chamran Highway, P.O. Box: 19395-4763, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzad Hadaegh
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Yemen Street, Shahid Chamran Highway, P.O. Box: 19395-4763, Tehran, Iran.
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Anderson BJ, Wahlquist AE, Hill EG, Marshall DT, Kimchi ET, Staveley O'Carroll KF, Camp ER. The impact of metabolic syndrome on outcome and response to neoadjuvant chemoradiation in locally advanced rectal cancer patients. Int J Surg 2016; 33 Pt A:8-12. [PMID: 27432024 DOI: 10.1016/j.ijsu.2016.07.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Accepted: 07/13/2016] [Indexed: 12/18/2022]
Abstract
BACKGROUND AND OBJECTIVES Metabolic syndrome (MetS) is a constellation of cardiovascular risk factors shown to increase the risk of developing various malignancies, as well as diminish tumor response to conventional therapies. The effects of MetS and its individual components on therapeutic response and treatment-related outcomes were examined in patients with locally advanced rectal cancer (LARC). METHODS Data was retrospectively collected on LARC patients treated with neoadjuvant chemoradiation (nCRT) and surgery. Medical records were reviewed for patient characteristics, staging, treatment plan, and outcomes. RESULTS One hundred two patients were included in the study. Patients with HTN had a significantly decreased nCRT response and were four times more likely to experience a poor response to treatment compared to patients without HTN. Additionally, HTN was found to significantly increase the rate of surgical complications. Neither DM nor obesity exhibited any significant effect on therapeutic response or complication rates, either individually or in combination with another risk factor. CONCLUSION This study demonstrates the importance of considering underlying MetS risk factors, especially HTN, when predicting tumor response in LARC patients undergoing nCRT followed by radical surgery. The results provide support for an increased focus on pre-treatment risk factor control to optimize cancer therapy outcomes.
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Affiliation(s)
- Brandon J Anderson
- Department of Surgery, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Amy E Wahlquist
- Department of Public Health Sciences, Charleston, SC 29425, USA; Hollings Cancer Center, Charleston, SC 29425, USA
| | - Elizabeth G Hill
- Department of Public Health Sciences, Charleston, SC 29425, USA; Hollings Cancer Center, Charleston, SC 29425, USA
| | | | - Eric T Kimchi
- Department of Surgery, Medical University of South Carolina, Charleston, SC 29425, USA; Hollings Cancer Center, Charleston, SC 29425, USA; Ralph H. Johnson VA Medical Center, Charleston, SC 29425, USA
| | - Kevin F Staveley O'Carroll
- Department of Surgery, Medical University of South Carolina, Charleston, SC 29425, USA; Hollings Cancer Center, Charleston, SC 29425, USA; Ralph H. Johnson VA Medical Center, Charleston, SC 29425, USA
| | - E Ramsay Camp
- Department of Surgery, Medical University of South Carolina, Charleston, SC 29425, USA; Hollings Cancer Center, Charleston, SC 29425, USA; Ralph H. Johnson VA Medical Center, Charleston, SC 29425, USA.
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Sha N, Xu H, Chen T, Tian DW, Xie WQ, Xie LG, Zhang Y, Xing C, Liu XT, Shen ZH, Wu ZL, Hu HL, Wu CL. The evaluation of the association between the metabolic syndrome and tumor grade and stage of bladder cancer in a Chinese population. Onco Targets Ther 2016; 9:1175-9. [PMID: 27022277 PMCID: PMC4789849 DOI: 10.2147/ott.s102424] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Objective The objective of this article was to summarize the relationship between some components of metabolic syndrome (MetS) and the histopathologic findings in bladder cancer in a Chinese population. Methods We retrospectively analyzed data of 323 patients from the Department of Urology, Second Hospital of Tianjin Medical University between January 2012 and January 2014. All the patients were diagnosed with bladder cancer for the first time. Age, height, weight, histologic stage, grade, the presence of hypertension, diabetes mellitus, and body mass index were evaluated. The 2009 American Joint Committee on Cancer TNM staging system was used, with Ta and T1 tumors accepted as lower stage and T2, T3, and T4 tumors as higher stage bladder cancers. Also, pathologists assigned tumor grade according to the 1973 World Health Organization grading system. Noninvasive papillary urothelial neoplasms of low malignant potential were regarded as low grade. Analyses were completed using chi-square tests and logistic regression analysis. Results Of the 323 patients, 164 had hypertension, 151 had diabetes mellitus, and 213 had a body mass index ≥25 kg/m2. MetS was significantly associated with histologic grade (P<0.001) and stage (P=0.006) of bladder cancer. Adjusted for age in binary logistic regression analysis, the presence of MetS predicts the risk of higher T stage (odds ratio =4.029, P<0.001) and grade (odds ratio =3.870, P<0.001) of bladder cancer. Conclusion The patients with MetS in the People’s Republic of China were found to have statistically significant higher T stage and grade of bladder cancer.
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Affiliation(s)
- Nan Sha
- Department of Urology, The Second Hospital of Tianjin Medical University, Tianjin, People's Republic of China; Tianjin Key Laboratory of Urology, Tianjin Institute of Urology, Tianjin, People's Republic of China
| | - Hao Xu
- Department of Urology, The Second Hospital of Tianjin Medical University, Tianjin, People's Republic of China; Tianjin Key Laboratory of Urology, Tianjin Institute of Urology, Tianjin, People's Republic of China
| | - Tao Chen
- Department of Urology, The Second Hospital of Tianjin Medical University, Tianjin, People's Republic of China; Tianjin Key Laboratory of Urology, Tianjin Institute of Urology, Tianjin, People's Republic of China
| | - Da-Wei Tian
- Department of Urology, The Second Hospital of Tianjin Medical University, Tianjin, People's Republic of China; Tianjin Key Laboratory of Urology, Tianjin Institute of Urology, Tianjin, People's Republic of China
| | - Wan-Qin Xie
- Key Laboratory of Genetics and Birth Health of Hunan province, Family Planning Research Institute of Hunan Province, Changsha, Hunan, People's Republic of China
| | - Lin-Guo Xie
- Department of Urology, The Second Hospital of Tianjin Medical University, Tianjin, People's Republic of China; Tianjin Key Laboratory of Urology, Tianjin Institute of Urology, Tianjin, People's Republic of China
| | - Yu Zhang
- Department of Urology, The Second Hospital of Tianjin Medical University, Tianjin, People's Republic of China; Tianjin Key Laboratory of Urology, Tianjin Institute of Urology, Tianjin, People's Republic of China
| | - Chen Xing
- Department of Urology, The Second Hospital of Tianjin Medical University, Tianjin, People's Republic of China; Tianjin Key Laboratory of Urology, Tianjin Institute of Urology, Tianjin, People's Republic of China
| | - Xiao-Teng Liu
- Department of Urology, The Second Hospital of Tianjin Medical University, Tianjin, People's Republic of China; Tianjin Key Laboratory of Urology, Tianjin Institute of Urology, Tianjin, People's Republic of China
| | - Zhong-Hua Shen
- Department of Urology, The Second Hospital of Tianjin Medical University, Tianjin, People's Republic of China; Tianjin Key Laboratory of Urology, Tianjin Institute of Urology, Tianjin, People's Republic of China
| | - Zhou-Liang Wu
- Department of Urology, The Second Hospital of Tianjin Medical University, Tianjin, People's Republic of China; Tianjin Key Laboratory of Urology, Tianjin Institute of Urology, Tianjin, People's Republic of China
| | - Hai-Long Hu
- Department of Urology, The Second Hospital of Tianjin Medical University, Tianjin, People's Republic of China; Tianjin Key Laboratory of Urology, Tianjin Institute of Urology, Tianjin, People's Republic of China
| | - Chang-Li Wu
- Department of Urology, The Second Hospital of Tianjin Medical University, Tianjin, People's Republic of China; Tianjin Key Laboratory of Urology, Tianjin Institute of Urology, Tianjin, People's Republic of China
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Dal Moro F, Bovo A, Crestani A, Vettor R, Gardiman MP, Zattoni F. Effect of hypertension on outcomes of high-risk patients after BCG-treated bladder cancer: a single-institution long follow-up cohort study. Medicine (Baltimore) 2015; 94:e589. [PMID: 25738480 PMCID: PMC4553954 DOI: 10.1097/md.0000000000000589] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Immunotherapy with Bacillus Calmette-Guérin (BCG) is the most efficacious treatment for high-risk bladder cancer (BC) (Ta/T1 or carcinoma in situ) to reduce the risk of recurrence. Our aim was to evaluate whether hypertension and diabetes influence the outcome of patients with noninvasive BC treated with BCG instillations.In order to collect homogeneous data, we considered as "hypertensive" only those patients who had previous diagnosed hypertension and a history of taking medical therapy with antihypertensive drugs (AHT), and as "diabetic" only those prescribed oral antidiabetics or insulin (ADT).We analyzed 343 high-risk BC patients undergoing BCG (1995-2010) with a median follow-up of 116 months (range 48-238). The distribution of various kinds of AHT and antidiabetic drugs was homogeneous, with no significant differences (p > 0.05).In both univariate and multivariate analyses, the only statistically significant parameter prognostic for recurrence after BCG treatment was AHT. Recurrence-free survival curves showed a significant correlation with AHT (p = 0.0168, hazards ratio [HR] 1.45, 95% confidence interval [CI] 1.0692-1.9619); there was no correlation (p = 0.9040) with ADT (HR 0.9750, 95% CI 0.6457-1.4721). After stratification of AHT and ADT according to drug(s) prescribed, there were no significant differences in the BC recurrence rate (p > 0.05).In this study with a very long-term follow-up, hypertension alone (evaluated by AHT) revealed the increased risk of BC recurrence after BCG treatment.Several hypotheses have been formulated to support these findings, but further prospective studies are needed to both evaluate the real influence of hypertension and identify a possible prognostic factor to be used in selecting poor-prognosis BC patients as early candidates for surgical treatment.
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Affiliation(s)
- Fabrizio Dal Moro
- From the Department of Surgical, Oncological and Gastroenterological Sciences-Urology (FDM, AB, AC, FZ); Department of Medicine DIMED (RV), Metabolic Diseases and Cardiovascular Risk Unit; and Department of Pathology (MPG), Azienda Ospedaliera di Padova, Padova, Italy
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Ozbek E, Otunctemur A, Dursun M, Koklu I, Sahin S, Besiroglu H, Erkoc M, Danis E, Bozkurt M. Association between the metabolic syndrome and high tumor grade and stage of primary urothelial cell carcinoma of the bladder. Asian Pac J Cancer Prev 2014; 15:1447-51. [PMID: 24606481 DOI: 10.7314/apjcp.2014.15.3.1447] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
PURPOSE To compare histopathologic findings of patients who underwent transurethral resection of a bladder tumor (TUR-B) between groups with and without the metabolic syndrome. MATERIALS AND METHODS We retrospectively analyzed data of 535 patients who underwent TUR-B in our department between October 2005 and March 2011. All patients had primary urethelial cell carcinoma (UCB). Histologic stage, grade, the presence of hypertension, diabetes mellitus, body mass index (BMI), waist circumference, HDL and trigliseride levels were evaluated. The TNM classification was used, with Ta tumor accepted as lower stage and T1 and T2 tumors as higher stage bladder cancers. Also, the pathological grading adopted by the 2004 World Health Organization grading system were applied. Non-invasive papillary urothelial neoplasms of low malignant potential were regarded as low grade. RESULTS Among the total of 509 patients analyzed in our study, there were 439 males (86.2%) and 70 females (13.8%). Metabolic syndrome was significantly associated with high histologic grade, and high pathologic stage (p<0.001). CONCLUSIONS The patients with metabolic syndrome were found to have statistically significant higher T stage and grade of bladder cancer. Further studies with more patients are needed to confirm our study.
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Affiliation(s)
- Emin Ozbek
- Okmeydani Training and Research Hospital Department of Urology, Istanbul, Turkey E-mail :
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Assimes TL, Suissa S. Age at incident treatment of hypertension and risk of cancer: a population study. Cancer Causes Control 2011; 20:1811-20. [PMID: 19533392 DOI: 10.1007/s10552-009-9374-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2008] [Accepted: 06/03/2009] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To determine the effect of treated hypertension on the risk of cancer. METHODS Population based external comparison study using the Saskatchewan Health databases. RESULTS A total of 42,270 subjects were followed for a median of 17.9 years after initiating antihypertensives for hypertension. The effect of hypertension on the risk of cancer varied significantly by age (interaction p < 0.001). Compared with the general population, subjects under 60 years at the time of initiation of antihypertensives had a significantly increased risk of cancer (RR 1.34, 95% CI 1.18–1.52 adjusted for age, sex, and calendar year) while subjects over 60 had a significantly decreased risk (RR 0.88, 95% CI 0.78–0.98). Similar results were obtained for cancer death outcomes. In each subgroup, relative risks across most cancer sites were similar in magnitude and direction. Results were essentially unchanged when analyses were restricted to cancers diagnosed after the first 10 years of follow-up. CONCLUSIONS The effect of treated hypertension on cancer risk varies by the age at incident treatment of hypertension.These findings are not a result of reverse causality or detection bias. However, they may in part be a consequence of residual confounding and/or reflect the type of hypertension being treated.
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Affiliation(s)
- Themistocles L Assimes
- Division of Cardiovascular Medicine, Stanford University School of Medicine, Falk Cardiovascular Research Building, 300 Pasteur Drive, Stanford, CA 94305-5406, USA.
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Häggström C, Stocks T, Rapp K, Bjørge T, Lindkvist B, Concin H, Engeland A, Manjer J, Ulmer H, Selmer R, Tretli S, Hallmans G, Jonsson H, Stattin P. Metabolic syndrome and risk of bladder cancer: prospective cohort study in the metabolic syndrome and cancer project (Me-Can). Int J Cancer 2011; 128:1890-8. [PMID: 20568111 DOI: 10.1002/ijc.25521] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
There are little data on the putative association between factors in the metabolic syndrome (MetS) and risk of bladder cancer. In the Metabolic Syndrome and Cancer project (Me-Can), measurements of height, weight, blood pressure and circulating levels of glucose, cholesterol, and triglycerides had been collected from 578,700 subjects in cohorts in Norway, Austria, and Sweden. We used Cox proportional hazard models to calculate relative risks (RRs) of bladder cancer by exposures divided into quintiles, in categories according to the World Health Organisation (WHO) and as a continuous standardized variable (z-score with mean = 0 and standard deviation = 1) for each separate component and its standardized sum, a composite MetS score. RRs were corrected for random error in measurements. During a mean follow-up of 11.7 years (SD = 7.6), 1,587 men and 327 women were diagnosed with bladder cancer. Significant associations with risk were found among men per one unit increment of z-score for blood pressure, RR = 1.13 (95% CI 1.03-1.25), and the composite MetS score, RR = 1.10 (95% CI 1.01-1.18). Among women, glucose was nonsignificantly associated with risk, RR = 1.41 (95% CI 0.97-2.06). No statistically significant interactions were found between the components in the MetS in relation to bladder cancer risk. Hypertension and a composite MetS score were significantly but modestly associated with an increased risk of bladder cancer among men and elevated glucose was associated with a nonsignificant increase in risk among women.
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Affiliation(s)
- Christel Häggström
- Department of Surgical and Perioperative sciences, Urology and Andrology, Umeå University, Umeå, Sweden.
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Relation of blood pressure components and categories and all-cause, stroke and coronary heart disease mortality in urban Chinese women: a population-based prospective study. J Hypertens 2009; 27:468-75. [PMID: 19262225 DOI: 10.1097/hjh.0b013e3283220eb9] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To determine whether various levels of blood pressure (BP), particularly normal and high normal BP or prehypertension, predict cardiovascular mortality among urban Chinese women. METHODS We evaluated the impact of all measures of BP on total mortality and stroke and coronary heart disease (CHD)-specific mortality in a population-based cohort study, the Shanghai Women's Health Study. Included in this analysis were 68 438 women aged 40-70 years at baseline for whom BP was assessed. RESULTS During an average of 5 years of follow-up, we identified 1574 deaths from all causes, 247 from stroke and 91 from CHD. Hypertension and higher levels of individual BP parameters including systolic BP, diastolic BP, pulse pressure, and mean arterial pressure were positively associated with all-cause, stroke, and CHD mortality (Ptrend < 0.05 for all except for DBP and CHD mortality). Prehypertension [adjusted hazard ratio (HRadj) = 1.65; 95% confidence interval, 0.98-2.78], particularly high normal BP (HRadj = 2.34; 95% confidence interval, 1.32-4.12), was associated with an increased risk of mortality from stroke. Hypertension accounted for 9.3% of mortality from all causes, 25.5% of mortality from stroke, and 21.7% mortality from CHD. High normal BP accounted for 10.8% of mortality from stroke. Isolated systolic BP also predicted stroke and mortality from CHD. CONCLUSION Hypertension is a significant contributor to mortality, particularly stroke and CHD mortality, among women in Shanghai. High normal BP is associated with high stroke mortality.
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