Increased mean arterial pressure was prospectively associated with a higher 45-year mortality risk from cardiovascular disease in men: the NHLBI Twin Study
Description
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. 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 Twin Study (NHLBI). 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. MAP ranged from 70 to 115 (median: 93.5) mm Hg. After adjustment for caloric intake, education, body mass index, marital status, and modified Framingham risk score, the overall association was marginally statistically significant through both 2010 [HR 1.07 (95% CI: 0.99–1.15; p=0.09)] and 2014 [1.01 (95% CI: 0.99–1.02; p=0.055]. For within-pair associations, the fully adjusted HR was 1.13 (95% CI: 0.99–1.29; p=0.07) through 2010 and 1.01 (95% CI: 1.0007–1.03; p=0.04) through 2014. An additional four years of follow-up beyond the initial 41 years revealed a positive but clinically insignificant association of MAP with cardiovascular death risk independent of known cardiovascular risk, genetic, and shared environmental factors.
Citation Information
Honarvar, Saam; Clark, Craig; and Dai, Jun, "Increased mean arterial pressure was prospectively associated with a higher 45-year mortality risk from cardiovascular disease in men: the NHLBI Twin Study" (2026). Office of Research DMU Research Symposium. 11.
https://digitalcommons.dmu.edu/researchsymposium/2025rs/2025abstracts/11
Increased mean arterial pressure was prospectively associated with a higher 45-year mortality risk from cardiovascular disease in men: the NHLBI Twin Study
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. 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 Twin Study (NHLBI). 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. MAP ranged from 70 to 115 (median: 93.5) mm Hg. After adjustment for caloric intake, education, body mass index, marital status, and modified Framingham risk score, the overall association was marginally statistically significant through both 2010 [HR 1.07 (95% CI: 0.99–1.15; p=0.09)] and 2014 [1.01 (95% CI: 0.99–1.02; p=0.055]. For within-pair associations, the fully adjusted HR was 1.13 (95% CI: 0.99–1.29; p=0.07) through 2010 and 1.01 (95% CI: 1.0007–1.03; p=0.04) through 2014. An additional four years of follow-up beyond the initial 41 years revealed a positive but clinically insignificant association of MAP with cardiovascular death risk independent of known cardiovascular risk, genetic, and shared environmental factors.
