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J Hum Hypertens. 1995 Mar;9(3):175-80.

Isolated systolic hypertension as a major risk factor for stroke and myocardial infarction and an unexploited source of cardiovascular prevention: a prospective population-based study.

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  • 1Copenhagen City Heart Study, Righospitalet, Denmark.


The purpose of this study was to determine the prevalence of isolated systolic hypertension (ISH) and associated risk of major cardiovascular events. The Copenhagen City Heart Study is a prospective population survey with cardiovascular examinations at 5-year intervals. Blood pressure measurement was carried out as office blood pressure. ISH was defined as SBP > or = 160 mmHg and DBP < 90 mm Hg. The risk of stroke and myocardial infarction (MI) in association with ISH was assessed using a multivariate Cox regression model. Follow-up was carried out by means of the National Patients Register and Death Register. The 19,698 subjects were randomly selected after age stratification from an area of central Copenhagen. Subjects (n = 6621) were included if > or = 50 years, not on anti-hypertensive or cardiac medicine, and had no history of a previous stroke or MI. Initial cases of verified stroke or MI were recorded from 1976 to 1988. The prevalence of ISH showed an age-related increase from 3% in the 55-year olds to 13% in the 72-year olds. No sex difference was found. Relative risk of stroke corrected for other risk factors was 3.0 (95% CI 1.6-5.3) for women and 2.7 (1.8-4.3) for men. This was the highest relative risk among all hypertensive groups. Relative risk of MI corrected for other risk factors was 0.8 (0.3-2.0) for women and 1.6 (1.0-2.5) for men. Population attributable risk for stroke associated with ISH is up to 30%.(ABSTRACT TRUNCATED AT 250 WORDS)

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