Association of orthostatic hypertension with mortality in the Systolic Hypertension in the Elderly Program.

We examined the association of orthostatic hypertension with all-cause mortality in the active treatment and placebo randomized groups of the Systolic Hypertension in the Elderly Program (SHEP). SHEP was a multicenter, randomized, double-blind, placebo-controlled clinical trial of the effect of chlorthalidone-based antihypertensive treatment on the rate of occurrence of stroke among older persons with isolated systolic hypertension (ISH). Men and women aged 60 years and above with ISH defined by a systolic blood pressure (SBP) of 160 mm Hg or higher and diastolic blood pressure lower than 90 mm Hg were randomized to chlorthalidone-based stepped care therapy or matching placebo.

Rapid decreases in blood pressure from antihypertensive treatment were associated with increased cancer mortality in the Systolic Hypertension in the Elderly Program.

Background: Research on the association between antihypertensive drug treatment (HTDT) and cancer is equivocal. We tested the hypothesis that large, rapid decreases in blood pressure following HTDT are associated with higher cancer mortality.

Methods: Data from the Systolic Hypertension in the Elderly Program (SHEP) with 15-year cause-specific follow-up for mortality were used.

Competing cardiovascular and noncardiovascular risks and longevity in the systolic hypertension in the elderly program.

We examined the effect of chlorthalidone-based stepped care on the competing risks of cardiovascular (CV) versus non-CV death in the Systolic Hypertension in the Elderly Program (SHEP). Participants were randomly assigned to chlorthalidone-based stepped-care therapy (n = 2,365) or placebo (n = 2,371) for 4.5 years, and all participants were advised to take active therapy thereafter.

Visit-to-visit blood pressure variability and cardiovascular death in the Systolic Hypertension in the Elderly Program.

Most studies of an association of visit-to-visit variability of blood pressure with increased risk of future adverse cardiovascular events are of short duration and rarely include a placebo group. Using data from the double-blind, placebo-controlled Systolic Hypertension in the Elderly Program, the authors examined mortality from cardiovascular causes up to 17 years of follow-up using the National Death Index. Visit-to-visit blood pressure variability was associated with cardiovascular death after adjustment for sex, age, serum creatinine, diabetes, body mass index, smoking status, left ventricular failure, and high-density lipoprotein cholesterol.

Cardiovascular outcomes after preeclampsia or eclampsia complicated by myocardial infarction or stroke.

Objective: To assess the relationship between preeclampsia or eclampsia and stroke, myocardial infarction (MI), subsequent cardiovascular outcomes, and long-term survival.

Methods: Using the Myocardial Infarction Data Acquisition System in New Jersey (1994-2009), we analyzed cardiovascular outcomes in women with and without preeclampsia or eclampsia and a first MI or stroke but with a hospitalization for a first MI or stroke (analysis 1: MI case group, n=57; MI control group, n=155; stroke case group, n=132; stroke control group, n=379). We also compared these outcomes in women with preeclampsia or eclampsia and a first MI or stroke during pregnancy with women with preeclampsia or eclampsia without MI or stroke during pregnancy (analysis 2: MI case group, n=23; MI control group, n=67; stroke case group, n=90; stroke control group, n=263).

Teen twin pregnancies: differences in fetal growth outcomes among blacks and whites.

We set out to determine the magnitude of black-white disparity in intrauterine fetal growth inhibition among twin births to teenagers (age 15 to 19) in the United States using a retrospective cohort study design. We compared the risk for low and very low birthweight, preterm and very preterm, and small for gestational age between black and white twins born to teen mothers during the period 1995 through 1998. The methodology of generalized estimating equations was used to adjust for the presence of intracluster correlation within twin pairs.

Influence of nativity on neonatal survival of Black twins in the United States.

Objective: To determine the association between maternal nativity and neonatal survival of twins among Black mothers.

Methods: We conducted a retrospective cohort study of twin live births to Black mothers in the United States from 1995 through 1998. We compared levels of overall, early, and late neonatal mortality between twins of US-born and those of foreign-born Black mothers by using hazard ratios generated from a Cox Proportional Hazards Regression model.