1. Hypothetical blood-pressure-lowering interventions and risk of stroke and dementia
- Author
-
Rojas-Saunero, L.P. (Liliana Paloma), Hilal, S. (Saima), Murray, E.J. (Eleanor J.), Logan, R.W. (Roger W.), Ikram, M.A. (Arfan), Swanson, S.A. (Sonja), Rojas-Saunero, L.P. (Liliana Paloma), Hilal, S. (Saima), Murray, E.J. (Eleanor J.), Logan, R.W. (Roger W.), Ikram, M.A. (Arfan), and Swanson, S.A. (Sonja)
- Abstract
We aimed to study the effects of hypothetical interventions on systolic blood pressure (SBP) and smoking on risk of stroke and dementia using data from 15 years of follow-up in the Rotterdam Study. We used data from 4930 individuals, aged 55–80 years, with no prior history of stroke, dementia or cognitive impairment, followed for 15 years within the Rotterdam Study, a population-based cohort. We defined the following sustained interventions on SBP: (1) maintaining SBP below 120 mmHg, (2) maintaining SBP below 140 mmHg, (3) reducing SBP by 10% if above 140 mmHg, (4) reducing SBP by 20% if above 140 mmHg, and a combined intervention of quitting smoking with each of these SBP-lowering strategies. We considered incident stroke and incident dementia diagnoses as outcomes. We applied the parametric g-formula to adjust for baseline and time-varying confounding. The observed 15-year risk for stroke was 10.7%. Compared to no specified intervention (i.e., the “natural course”), all interventions that involved reducing SBP were associated with a stroke risk reduction of about 10% (e.g., reducing SBP by 20% if above 140 mmHg risk ratio: 0.89; 95% CI 0.76, 1). Jointly i
- Published
- 2020
- Full Text
- View/download PDF