1. Hazard ratio (& 95% CI) for 20 mmHg lower usual systolic BP
PSC: Age-specific relevance of usual blood pressure to vascular mortality
Vascular mortality: Age-specific hazard ratios for 20 mmHg lower usual SBP
deaths at ages 40-89
No. of
deaths
414
0·36 (0·32-0·40)
1372
0·38 (0·35-0·40)
2939
0·43 (0·41-0·45)
4327
0·50 (0·48-0·52)
2636
0·67 (0·63-0·71)
1322
0·49 (0·45-0·53)
5594
0·50 (0·49-0·52)
10 450
0·54 (0·53-0·55)
10 852
0·60 (0·58-0·61)
5649
0·67 (0·64-0·70)
Cause
of death
Stroke
IHD
Other
vascular
386
0·43 (0·38-0·48)
1377
0·50 (0·47-0·54)
2549
0·53 (0·51-0·56)
3227
0·64 (0·61-0·67)
Age at
risk
40-49
50-59
60-69
70-79
80-89
2251
0·70 (0·65-0·75)
0·25
0·35
0·5
0·7
1·0
Hazard ratio (& 95% CI) for
20 mmHg lower usual systolic BP
Figure 1a: Stroke, IHD and other vascular mortality: Age-specific hazard ratios for given differences in usual SBP. The values plotted are the hazard ratios in each decade of age associated with 20 mmHg lower usual SBPat the start of that decade. Each square has area inversely proportional to the effective variance of the log hazard ratio, with the vertical broken line indicating a hazard ratio of 0·5. In parallel analyses of the large MRFIT study, a 20 mmHg lower usual SBP at the start of the decade for deaths at ages 40-49, & respectively was associated with hazard ratios (& 95% CIs) of (i) stroke: 0·30 (0·23-0·40), 0·33 (0·29-0·38) & 0·35 (0·31-0·40); (ii) IHD: 0·42 (0·38-0·47), 0·44 (0·42-0·46) & 0·46 (0·44-0·48); and (iii) other vascular: 0·35 (0·30-0·42), 0·42 (0·39-0·46) & 0·44 (0·41-0·48). 1
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2. Hazard ratio (& 95% CI) for 10 mmHg lower usual diastolic BP
PSC: Age-specific relevance of usual blood pressure to vascular mortality
Vascular mortality: Age-specific hazard ratios for 10 mmHg lower usual DBP (³ 75 mmHg)
deaths at ages 40-89
No. of
deaths
348
1243
2626
3915
2340
1114
4945
9289
9727
5068
Cause
of death
Stroke
IHD
Other
vascular
316
1140
2220
2853
Age at
risk
40-49
50-59
60-69
70-79
80-89
1976
0·35 (0·30-0·40)
0·34 (0·32-0·37)
0·40 (0·38-0·42)
0·48 (0·45-0·51)
0·63 (0·58-0·69)
0·47 (0·43-0·51)
0·52 (0·50-0·55)
0·56 (0·54-0·58)
0·62 (0·60-0·64)
0·70 (0·65-0·74)
0·43 (0·37-0·50)
0·48 (0·44-0·52)
0·49 (0·46-0·53)
0·61 (0·57-0·66)
0·71 (0·64-0·79)
0·25
0·35
0·5
0·7
1·0
Hazard ratio (& 95% CI) for
10 mmHg lower usual diastolic BP
Figure 1b: Stroke, IHD and other vascular mortality: Age-specific hazard ratios for given differences in usual DBP. The values plotted are the hazard ratios in each decade of age associated with 10 mmHg lower usual DBP at the start of that decade. Each square has area inversely proportional to the effective variance of the log hazard ratio, with the vertical broken line indicating a hazard ratio of 0·5. 2
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3. (floating absolute risks & 95% CI)
PSC: Age-specific relevance of usual blood pressure to vascular mortality
Stroke mortality rate in each decade of age versus usual SBP at the start of that decade
deaths at ages
Age at risk: 20 mmHg  SBP
%  risk
%  risk
%  risk
%  risk
( %  risk)
Usual systolic blood pressure (mmHg)
(floating absolute risks & 95% CI)
Stroke mortality
120
140
160
180 1 2 4 8 16 32 64
128
256
Figure 2a: Stroke mortality rate in each decade of age versus usual SBP at the start of that decade.
Rates are plotted on a floating absolute scale, and each square has area inversely proportional to the effective variance of the log mortality rate. 3
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4. (floating absolute risks & 95% CI)
PSC: Age-specific relevance of usual blood pressure to vascular mortality
Stroke mortality rate in each decade of age versus usual DBP at the start of that decade
deaths at ages
Age at risk: 10 mmHg  SBP
%  risk
%  risk
%  risk
%  risk
( %  risk) 70 80 90
100
110 1 2 4 8 16 32 64
128
256
(floating absolute risks & 95% CI)
Stroke mortality
Figure 2b: Stroke mortality rate in each decade of age versus usual DBP at the start of that decade.
Rates are plotted on a floating absolute scale, and each square has area inversely proportional to the effective variance of the log mortality rate. For DBP, each age-specific regression line ignores the left-hand point (i.e. at slightly less than 75 mmHg), for which the risk lies significantly above the fitted line (as indicated by the broken line below 75 mmHg).
Usual diastolic blood pressure (mmHg) 4
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5. Hazard ratio (& 95% CI) for 20 mmHg lower usual systolic BP
PSC: Age-specific relevance of usual blood pressure to vascular mortality
Stroke mortality: Age- and sex-specific hazard ratios for 20 mmHg lower usual SBP
deaths at ages 40-89
Sex
No. of
deaths
40-49
Male
279
0·33 (0·29-0·38)
Female
135
0·41 (0·34-0·49)
Both
414
0·36 (0·32-0·40)
50-59
989
0·34 (0·32-0·37)
383
0·45 (0·40-0·50)
1372
0·38 (0·35-0·40)
60-69
2116
0·41 (0·39-0·44)
823
0·47 (0·43-0·51)
2939
0·43 (0·41-0·45)
70-79
2599
0·48 (0·46-0·51)
1728
0·53 (0·49-0·56)
4327
0·50 (0·48-0·52)
80-89
1238
0·68 (0·63-0·75)
1398
0·65 (0·60-0·71)
2636
0·67 (0·63-0·71)
0·25
0·35
0·5
0·7
1·0
Age at
risk
Figure 3a: Stroke mortality: Sex-specific hazard ratios for 20 mmHg lower usual SBP.
Conventions as in Figure 1a.
Hazard ratio (& 95% CI) for
20 mmHg lower usual systolic BP 5
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6. Hazard ratio (& 95% CI) for 20 mmHg lower usual systolic BP
PSC: Age-specific relevance of usual blood pressure to vascular mortality
Stroke mortality (by sub-type): Age-specific hazard ratios for 20 mmHg lower usual SBP
deaths at ages 40-89
0·44 (0·36-0·53)
0·31 (0·26-0·38)
0·44 (0·31-0·64)
0·29 (0·22-0·39)
0·36 (0·32-0·40)
0·50 (0·43-0·58)
0·38 (0·34-0·43)
0·35 (0·29-0·41)
0·34 (0·30-0·38)
0·38 (0·35-0·40)
0·47 (0·40-0·55)
0·43 (0·39-0·47)
0·45 (0·41-0·51)
0·44 (0·41-0·47)
0·43 (0·41-0·45)
0·76 (0·58-0·99)
0·51 (0·47-0·56)
0·50 (0·45-0·55)
0·49 (0·46-0·52)
0·50 (0·48-0·52)
Age at
risk
40-49
50-59
60-69
70-79
80-89
1·03 (0·56-1·89)
0·51 (0·43-0·60)
0·77 (0·67-0·87)
0·67 (0·62-0·72)
Type of
stroke
S.A.H.
C. Haem
C. Isch
Unknown
Any strokes
No. of
deaths
150
157 46 61
414
301
462
177
432
1372
271
741
538
1389
2939
107
915
850
2455
4327 33
423
518
1662
2636
0·67 (0·63-0·71)
0·25
0·35
0·5
0·7
1·0
Figure 3b: Type-specific stroke mortality: hazard ratios for 20 mmHg lower usual SBP.
Conventions as in Figure 1a. Hazard ratios (& 95% CIs) for subarachnoid haemorrhage (SAH) are given numerically but are not plotted.
Hazard ratio (& 95% CI) for
20 mmHg lower usual systolic BP 6
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7. (floating absolute risks & 95% CI)
PSC: Age-specific relevance of usual blood pressure to vascular mortality
IHD mortality rate in each decade of age versus usual SBP at the start of that decade
deaths at ages
Age at risk 20 mmHg  SBP
%  risk
%  risk
%  risk
%  risk
%  risk
Usual systolic blood pressure (mmHg)
120
140
160
180 1 2 4 8 16 32 64
128
256
(floating absolute risks & 95% CI)
IHD mortality
Figure 4a: IHD mortality rate in each decade of age versus usual SBP at the start of that decade.
Conventions as in Figure 2a. 7
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8. (floating absolute risks & 95% CI)
PSC: Age-specific relevance of usual blood pressure to vascular mortality
IHD mortality rate in each decade of age versus usual DBP at the start of that decade
deaths at ages
Age at risk 10 mmHg  DBP
%  risk
%  risk
%  risk
%  risk
%  risk
Usual diastolic blood pressure (mmHg) 70 80 90
100
110 1 2 4 8 16 32 64
128
256
(floating absolute risks & 95% CI)
IHD mortality
Figure 4b: IHD mortality rate in each decade of age versus usual DBP at the start of that decade.
Conventions as in Figure 2b. 8
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9. Hazard ratio (& 95% CI) for 20 mmHg lower usual systolic BP
PSC: Age-specific relevance of usual blood pressure to vascular mortality
IHD mortality: Age- and sex-specific hazard ratios for 20 mmHg lower usual SBP
deaths at ages 40-89
Age at
risk
Sex
No. of
deaths
40-49
Male
1202
0·50 (0·46-0·54)
Female
120
0·40 (0·32-0·49)
Both
1322
0·49 (0·45-0·53)
50-59
5027
0·50 (0·49-0·52)
567
0·49 (0·45-0·54)
5594
60-69
8609
0·55 (0·54-0·57)
1841
0·50 (0·47-0·53)
10 450
0·54 (0·53-0·55)
70-79
7384
0·62 (0·60-0·64)
3468
0·55 (0·53-0·58)
10 852
0·60 (0·58-0·61)
80-89
2932
0·69 (0·65-0·73)
2717
0·64 (0·60-0·68)
5649
0·67 (0·64-0·70)
0·25
0·35
0·5
0·7
1·0
Hazard ratio (& 95% CI) for
20 mmHg lower usual systolic BP
Figure 5: IHD mortality: Sex-specific hazard ratios for 20 mmHg lower usual SBP.
Conventions as in Figure 1a. 9
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10. PSC: Age-specific relevance of usual blood pressure to vascular mortality
Other vascular mortality rate in each decade of age versus usual SBP at the start of that decade
9790 deaths at ages 50-89
Usual systolic blood pressure (mmHg)
120
140
160
180 32 1 2 4 8 16 64
128
256
Other vascular mortality (not stroke or IHD)
(floating absolute risks & 95% CI)
Age at risk: 20 mmHg  SBP
%  risk
%  risk
%  risk
%  risk
( %  risk)
Figure 6a: Other vascular (not stroke or IHD) mortality rate in each decade of age versus usual SBP at the start of that decade.
Conventions as in Figure 2a. 10
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11. PSC: Age-specific relevance of usual blood pressure to vascular mortality
Other vascular mortality rate in each decade of age versus usual DBP at the start of that decade
9790 deaths at ages 50-89
Usual diastolic blood pressure (mmHg) 70 80 90
100
110 1 2 4 8 16 32 64
128
256
Other vascular mortality (not stroke or IHD)
(floating absolute risks & 95% CI)
Age at risk: 10 mmHg  DBP
%  risk
%  risk
%  risk
%  risk
( %  risk)
Figure 6b: Other vascular (not stroke or IHD) mortality rate in each decade of age versus usual DBP at the start of that decade.
Conventions as in Figure 2b. 11
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12. Hazard ratio (& 95% CI) for 20 mmHg lower usual systolic BP
PSC: Age-specific relevance of usual blood pressure to vascular mortality
Mortality from other vascular causes (not stroke or IHD): Hazard ratios for 20 mmHg lower usual SBP
9 790 deaths at ages 40-89
Cause of
Mean age
No. of
death
at death
deaths
Heart Failure 68
746
0·53 (0·48-0·59)
Aortic Aneurysm 68
705
0·55 (0·49-0·62)
Hypertensive HD 68
649
0·22 (0·20-0·25)
Atherosclerosis 72
508
0·48 (0·42-0·55)
Sudden death 60
553
0·49 (0·43-0·56)
Inflammatory HD 67
320
0·63 (0·53-0·75)
Rheumatic HD 64
255
0·74 (0·61-0·89)
Other HD (excl. IHD) 69
1682
0·62 (0·58-0·67)
Pulmonary embolism 67
296
0·72 (0·60-0·87)
Figure 7: Mortality from other vascular causes (not stroke or IHD): Hazard ratios for 20 mmHg lower usual SBP.
Conventions as in Figure 1a. Only 54 of the studies subdivided these other vascular causes (Table A1 in Annex A).
Other circulatory 65
182
0·56 (0·44-0·71)
0·25
0·35
0·5
0·7
1·0
Hazard ratio (& 95% CI) for
20 mmHg lower usual systolic BP 12
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13. (floating absolute risks & 95% CI)
PSC: Age-specific relevance of usual blood pressure to vascular mortality
IHD mortality rate in each decade of age versus usual mid blood pressure at the start of that decade
deaths at ages
100
110
120
130
140
150 1 2 4 8 16 32 64
128
256
Usual mid blood pressure (mmHg)
(floating absolute risks & 95% CI)
IHD mortality
Figure 4a: IHD mortality rate in each decade of age versus usual SBP at the start of that decade.
Conventions as in Figure 2a. 13
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