Abstract TU259: Increased Mean Arterial Pressure Was Prospectively Associated With a Higher 45-year Mortality Risk From Cardiovascular Disease In Men: The NHLBI Twin Study

Abstract

Saam Honarvar, D.O. ’28, MPH 1 ; Craig Clark, D.O. 2 ; Jun Dai, M.D., M.Sc., Ph.D. 3 Affiliations: 1 College of Osteopathic Medicine, Des Moines University, West Des Moines, Iowa 2 Master of Science in Physician Assistant, College of Health Sciences, Des Moines University, West Des Moines, Iowa 3 Department of Public Health, College of Health Sciences, Des Moines University, West Des Moines, Iowa Background: Mean arterial pressure (MAP) is a cardiovascular risk factor and better reflects vascular load and perfusion than systolic (SBP) or diastolic blood pressure (DBP) alone. However, it is unclear if MAP is prospectively associated with cardiovascular death risk independent of genetic and common environmental factors. Method: A total of 639 white male twins [129 monozygotic and 116 dizygotic pairs, and 64 monozygotic and 85 dizygotic unpaired twins] aged 42–55 years at baseline (1969–1973), free of cardiovascular disease and hypertension, were followed up until December 31, 2010, or 2014 in the National Heart, Lung, and Blood Institute (NHLBI) Twin Study. The baseline MAP was calculated from baseline SBP and DBP. Frailty survival models were used to evaluate the association of MAP with cardiovascular death risk and to estimate hazard ratios (HRs) per 10 mm Hg increment in MAP. Results: Baseline MAP ranged from 70 to 115 (median: 93.5) mm Hg. After adjustment for caloric intake, alcohol intake, education, body mass index, marital status, and modified Framingham risk score, the overall association was statistically significant [HR 1.09 (95% CI: 1.01–1.17; p =0.03) for follow-up through both 2010 and 2014]. For within-pair associations, the fully adjusted HR was 1.17 (95% CI: 1.02–1.34; p =0.03) through 2010 and 1.16 (95% CI: 1.02–1.33; p =0.03) through 2014. Conclusion: Mean arterial pressure is positively associated with cardiovascular death risk, with a similar magnitude, during both 41 and 45 years of follow-up, independent of known cardiovascular risk factors, genetic, and shared environmental factors. Funding Support: This study was funded by the U.S. National Institutes of Health (grant number HL51429 to the NHLBI Twin Study) and the Mentored Student Research Program at Des Moines University.