Blood pressure and mortality: using offspring blood pressure as an instrument for own blood pressure in the HUNT study

Blood pressure and mortality: using offspring blood pressure as an instrument for own blood pressure in the HUNT study

Given that observational associations may be inaccurate, we used offspring blood pressure (BP) to provide alternative estimates of the associations between own BP and mortality. Observational associations between BP and mortality, estimated as hazard ratios (HRs) from Cox regression, were compared t...

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Main Authors: Wade, Kaitlin H, Carslake, David, Ivar Nilsen, Tom, Timpson, Nicholas J, Davey Smith, George, Romundstad, Pål
Format: Online
Language:English
Published: Nature Publishing Group 2015
Online Access:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4510525/
id pubmed-4510525
recordtype oai_dc
spelling pubmed-45105252015-07-28 Blood pressure and mortality: using offspring blood pressure as an instrument for own blood pressure in the HUNT study Wade, Kaitlin H Carslake, David Ivar Nilsen, Tom Timpson, Nicholas J Davey Smith, George Romundstad, Pål Article Given that observational associations may be inaccurate, we used offspring blood pressure (BP) to provide alternative estimates of the associations between own BP and mortality. Observational associations between BP and mortality, estimated as hazard ratios (HRs) from Cox regression, were compared to HRs obtained using offspring BP as an instrumental variable (IV) for own BP (N = 32,227 mother-offspring and 27,535 father-offspring pairs). Observationally, there were positive associations between own BP and mortality from all-causes, cardiovascular disease (CVD), coronary heart disease (CHD), stroke and diabetes. Point estimates of the associations between BP and mortality from all-causes, CVD and CHD were amplified in magnitude when using offspring BP as an IV. For example, the HR for all-cause mortality per standard deviation (SD) increase in own systolic BP (SBP) obtained in conventional observational analyses increased from 1.10 (95% CI: 1.09–1.12; P < 0.0001) to 1.31 (95% CI: 1.19–1.43; P < 0.0001). Additionally, SBP was positively associated with diabetes and cancer mortality (HRs: 2.00; 95% CI: 1.12–3.35; P = 0.02 and 1.20; 95% CI: 1.02–1.42; P = 0.03, respectively), and diastolic BP (DBP) with stroke mortality (HR: 1.30; 95% CI: 1.02–1.66; P = 0.03). Results support positive associations between BP and mortality from all-causes, CVD, and CHD, SBP on cancer mortality, and DBP on stroke mortality. Nature Publishing Group 2015-07-22 /pmc/articles/PMC4510525/ /pubmed/26198310 http://dx.doi.org/10.1038/srep12399 Text en Copyright © 2015, Macmillan Publishers Limited http://creativecommons.org/licenses/by/4.0/ This work is licensed under a Creative Commons Attribution 4.0 International License. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/
repository_type Open Access Journal
institution_category Foreign Institution
institution US National Center for Biotechnology Information
building NCBI PubMed
collection Online Access
language English
format Online
author Wade, Kaitlin H
Carslake, David
Ivar Nilsen, Tom
Timpson, Nicholas J
Davey Smith, George
Romundstad, Pål
spellingShingle Wade, Kaitlin H
Carslake, David
Ivar Nilsen, Tom
Timpson, Nicholas J
Davey Smith, George
Romundstad, Pål
Blood pressure and mortality: using offspring blood pressure as an instrument for own blood pressure in the HUNT study
author_facet Wade, Kaitlin H
Carslake, David
Ivar Nilsen, Tom
Timpson, Nicholas J
Davey Smith, George
Romundstad, Pål
author_sort Wade, Kaitlin H
title Blood pressure and mortality: using offspring blood pressure as an instrument for own blood pressure in the HUNT study
title_short Blood pressure and mortality: using offspring blood pressure as an instrument for own blood pressure in the HUNT study
title_full Blood pressure and mortality: using offspring blood pressure as an instrument for own blood pressure in the HUNT study
title_fullStr Blood pressure and mortality: using offspring blood pressure as an instrument for own blood pressure in the HUNT study
title_full_unstemmed Blood pressure and mortality: using offspring blood pressure as an instrument for own blood pressure in the HUNT study
title_sort blood pressure and mortality: using offspring blood pressure as an instrument for own blood pressure in the hunt study
description Given that observational associations may be inaccurate, we used offspring blood pressure (BP) to provide alternative estimates of the associations between own BP and mortality. Observational associations between BP and mortality, estimated as hazard ratios (HRs) from Cox regression, were compared to HRs obtained using offspring BP as an instrumental variable (IV) for own BP (N = 32,227 mother-offspring and 27,535 father-offspring pairs). Observationally, there were positive associations between own BP and mortality from all-causes, cardiovascular disease (CVD), coronary heart disease (CHD), stroke and diabetes. Point estimates of the associations between BP and mortality from all-causes, CVD and CHD were amplified in magnitude when using offspring BP as an IV. For example, the HR for all-cause mortality per standard deviation (SD) increase in own systolic BP (SBP) obtained in conventional observational analyses increased from 1.10 (95% CI: 1.09–1.12; P < 0.0001) to 1.31 (95% CI: 1.19–1.43; P < 0.0001). Additionally, SBP was positively associated with diabetes and cancer mortality (HRs: 2.00; 95% CI: 1.12–3.35; P = 0.02 and 1.20; 95% CI: 1.02–1.42; P = 0.03, respectively), and diastolic BP (DBP) with stroke mortality (HR: 1.30; 95% CI: 1.02–1.66; P = 0.03). Results support positive associations between BP and mortality from all-causes, CVD, and CHD, SBP on cancer mortality, and DBP on stroke mortality.
publisher Nature Publishing Group
publishDate 2015
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4510525/
_version_ 1613250447935537152

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