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Abstract P188: Repeated Blood Pressure Measurements in Relation to Cardiovascular and All[[Unable to Display Character: ‑]]cause Mortality in Individuals with and without Antihypertensive Medication: The Rancho Bernardo Study


 Introduction:
 The predictive value of systolic blood pressure (SBP) for cardiovascular disease (CVD) in individuals using antihypertensive medication has not yet been established in epidemiological studies. We investigated the association of average SBP and SBP trajectories with CVD and all-cause mortality, accounting for antihypertensive medication.
 
 
 Methods:
 Data from 762 participants from the Rancho Bernardo Study were used. Five examinations took place from 1984 - 2002; mortality data were obtained from 2002 - 2013. Average SBP was defined as the mean of all available SBP levels between 1984 - 2002 and SBP trajectories over this period were derived using groupbased trajectory modeling. Cox proportional hazards analysis was used to investigate associations of average SBP and SBP trajectories with CVD and all-cause mortality, adjusted for age, sex, plasma cholesterol, smoking, diabetes, and antihypertensive medication. We examined whether use of antihypertensive medication modified these associations by means of interaction terms in the multivariable models.
 
 
 Results:
 Mean (± SD) baseline age was 65.7 ± 8.4 years, and 67% were female. During a median follow-up of 11.7 years, 286 participants died, 34% due to CVD. For average SBP, each 20-mm Hg increment was associated with a 1.4-times greater CVD mortality risk and 1.2-times all-cause mortality risk (Table 1). For SBP trajectories
 ,
 the highest trajectories were associated with a 2-to-3-times greater CVD mortality risk and 1.5-times greater all-cause mortality risk, compared with the lowest trajectory. These associations were not modified by antihypertensive medication (
 P
 for interaction >0.10).
 
 
 Conclusions:
 In the general middle-aged and older population of the Rancho Bernardo Study, long-term average SBP levels and trajectories were significant predictors of CVD and all-cause mortality, irrespective of prescribed antihypertensive medication in the 1980s and 1990s.
 
 
 
