***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: We compared systolic blood pressure ( SBP ) , diastolic blood pressure ( DBP ) , pulse pressure ( PP ) , and mean arterial pressure ( MAP ) in predicting the risk of cardiovascular disease ( CVD ) , stratifying results at age 60 years , when DBP decreases while SBP continues to increase . We prospect ively followed 11 150 male physicians with no history of CVD or antihypertensive treatment through the 2-year question naire  ,  after which follow-up began . Reported blood pressure was averaged from both the baseline and 2-year question naires . During a median follow-up of 10.8 years , there were 905 cases of incident CVD . For men aged < 60 years ( n=8743 ) , those in the highest versus lowest quartiles of average SBP ( ≥130 versus < 116 mm Hg ) , DBP ( ≥81 versus < 73 mm Hg ) , and MAP ( ≥97 versus < 88 mm Hg ) had relative risks ( RRs ) of CVD of 2.16 , 2.23 , and 2.52 , respectively . Models with average MAP and PP did not add information compared with models with MAP alone ( P > 0.05 ) . For men aged ≥60 years ( n=2407 ) , those in the highest versus lowest quartiles of average SBP ( ≥135 versus < 120 mm Hg ) , PP ( ≥55 versus < 44 mm Hg ) , and MAP ( ≥99 versus < 91 mm Hg ) had RRs of CVD of 1.69 , 1.83 , and 1.43 , respectively . The addition of other blood pressure measures did not add information compared with average SBP or PP alone ( all P > 0.05 ) . These data suggest that average SBP , DBP , and MAP strongly predict  CVD among younger men , whereas either average SBP or PP predicts CVD among older men . More research should distinguish whether MAP , highly correlated with SBP and DBP , better predicts CVD Background An effect of diet in determining blood pressure is suggested by epidemiological studies , but the role of specific nutrients is still unsettled . Methods and Results The relation of various nutritional factors with hypertension was examined prospect ively among 30,681 predominantly white US male health professionals , 40–75 years old , without diagnosed hypertension . During 4 years of follow-up , 1,248 men reported a diagnosis of hypertension . Age , relative weight , and alcohol consumption were the strongest predictors for the development of hypertension . Dietary fiber , potassium , and magnesium were each significantly associated with lower risk of hypertension when considered individually and after adjustment for age , relative weight , alcohol consumption , and energy intake . When these nutrients were considered simultaneously , only dietary fiber had an independent inverse association with hypertension . For men with a fiber intake of < 12 g/day , the relative risk of hypertension was 1.57 ( 95 % confidence interval , 1.20–2.05 ) compared with an intake of > 24 g/day . Calcium was significantly associated with lower risk of hypertension only in lean men .  Dietary fiber , potassium , and magnesium were also inversely related to baseline systolic and diastolic blood pressure and to change in blood pressure during the follow-up among men who did not develop hypertension . Calcium was inversely associated with baseline blood pressure but not with change in blood pressure . No significant associations with hypertension were observed for sodium , total fat , or saturated , transunsaturated , and polyunsaturated fatty acids .  Fruit fiber but not vegetable or cereal fiber was inversely associated with incidence of hypertension . Conclusions These results support hypotheses that an increased intake of fiber and magnesium may contribute to the prevention of hypertension CONTEXT For women , impact of cardiovascular risk factors measured in young adulthood , particularly favorable ( low-risk ) profile , on mortality has been difficult to assess due to low short-term death rates . OBJECTIVE To assess the relationship of baseline coronary risk factor status to mortality from coronary heart disease ( CHD ) , cardiovascular diseases ( CVDs ) , and all causes in young women . DESIGN Prospect i ve cohort study . SETTING AND PARTICIPANTS A total of 7302 women aged 18 to 39 years without prior CHD or major electrocardiographic abnormalities screened between 1967 and 1973 for the Chicago Heart Association Detection Project in Industry . Risk groups were defined using national guidelines for values of systolic and diastolic blood pressure , serum cholesterol level , body mass index , presence of diabetes , and smoking status . Participants were divided into 4 groups : low risk , 0 risk factors high but 1 or more unfavorable , 1 only risk factor high , and 2 or more risk factors high . MAIN OUTCOME MEASURES All-cause mortality , CHD mortality , and CVD mortality ; hazard ratio of outcome measures comparing low-risk group with other groups . RESULTS Only 20 % met low-risk criteria ; 59 % had high levels of 1 or more risk factors . During an average follow-up of 31 years , there were 47 CHD deaths , 94 CVD deaths , and 469 deaths from all causes . The age-adjusted CVD death rate per 10,000 person-years was lowest for low-risk women and increased with the number of risk factors , ie , 1.5 , 1.7 , 5.0 , and 9.1 for low-risk ; 0 , 1 , and 2 or more risk factors high , respectively . Multivariate-adjusted CVD mortality hazard ratio for low-risk women was 0.19 ( 95 % confidence interval , 0.08 - 0.45 ) compared with women with 2 or more risk factors high . Similar patterns were observed for CHD and all-cause mortality and for both blacks and whites . CONCLUSION For women with favorable levels for all 5 major risk factors at younger ages , CHD and CVD are rare ; long-term and all-cause mortality are much lower compared with others Background —Low systolic blood pressure ( SBP ) is a risk factor for adverse outcomes in patients with heart failure ( HF ) .  Valsartan improved morbidity rates in the Valsartan Heart Failure Trial ( Val-HeFT ) despite a reduction in SBP . The aim of the present study was to investigate the relationship between the SBP-lowering effects of valsartan and its cardiovascular protective effects in this population . Methods and Results —Baseline measurements and changes in SBP at 4 months were related to mortality and morbidity rates . The effects of valsartan on these end points were compared in quartiles of baseline SBP with multivariable Cox proportional hazards regression models that included a test for interaction between the effects of valsartan treatment and baseline SBP and examined the effects of changes in SBP on the valsartan effect . The mean±SD baseline SBP in all patients ( n=5010 ) was 124±18 mm Hg . Patients in the lowest quartile of SBP ( SBP ≤110 mm Hg ; mean SBP 102 mm Hg ; n=940 ) had more severe HF and a significantly increased adjusted risk of death ( hazard ratio [ HR ] , 1.21 ; 95 % confidence interval [ CI ] , 1.03 to 1.43 ; P=0.02 ) , first morbid event ( HR , 1.25 ; 95 % CI , 1.10 to 1.40 ; P=0.001 ) , and hospitalization for HF ( HR , 1.45 ; 95 % CI , 1.22 to 1.73 ; P<0.001 ) than did patients in the upper 3 quartiles of baseline SBP ( mean SBP 130 mm Hg ; n=3260 ) . Valsartan  reduced SBP in patients in the upper 3 quartiles but not in patients in the lowest quartile who had a baseline SBP < 110 mm Hg . Valsartan was associated with decreases in the risks of first morbid event ( HR , 0.74 ; 95 % CI , 0.60 to 0.91 ; P=0.005 ) and hospitalization for HF ( HR , 0.60 ; 95 % CI , 0.45 to 0.79 ; P<0.001 ) in the lowest quartile that were not significantly different than the valsartan effects in the other 3 quartiles combined ( first morbid event HR , 0.90 ; 95 % CI , 0.79 to 1.02 ; P=0.10 ; and HF hospitalization HR , 0.77 ; 95 % CI , 0.64 to 0.93 ; P=0.006 ; nonsignificant interactions ) . The decrease in SBP from baseline to 4 months was an independent risk factor for subsequent events . When changes in SBP were added to the regression model , the effects of valsartan in the lowest quartile and in the other 3 quartiles combined did not change substantially . Conclusion —Baseline SBP and a decrease in SBP over time were risk factors for adverse events in HF . Valsartan reduced SBP but not in the high-risk group of patients who had a baseline SBP < 110 mm Hg . The beneficial effects of valsartan did not vary significantly with baseline SBP , and decreases in SBP did not counteract the beneficial effects on HF morbidity rates We compared the relations of 4 blood pressure ( BP ) indexes ( pulse pressure [ PP ] , systolic BP [ SBP ] , diastolic BP [ DBP ] , and mean arterial pressure [ MAP ] ) with 25-year mortality rates for coronary heart disease ( CHD ) , cardiovascular disease ( CVD ) , and all causes in younger , middle-aged , and older men and women by using data from a long-term prospect i ve epidemiological study of employed persons who were screened between 1967 and 1973 . A single supine BP measurement was obtained at baseline . Vital status was determined through 1995 . We report on 5 groups ( total , 28 360 participants ) consisting of men age 18 to 39 , 40 to 59 , and 60 to 74 years and of women age 40 to 59 and 60 to 74 years who were not receiving antihypertensive treatment , had no history of CHD , and did not have diabetes . Cox proportional hazards analyses were used to determine multivariate-adjusted hazard ratios with a 1-SD higher value for each BP index ; Wald & khgr;2 tests were used to compare the strength of relations . Relations of PP were less strong than were those of SBP for all end points in all age/gender groups . SBP or MAP showed the strongest relations to all end points in all age/gender groups ( hazard ratio , 1.17 to 1.36 ) . The relations of SBP to death were stronger than were those of DBP , except for middle-aged men and for CVD in women . DBP showed significant positive associations with death , after control for SBP , in middle-aged participants . In conclusion , these data indicate that the long-term risk of high BP should be assessed mainly on the basis of SBP or of SBP and DBP together , not on the basis of PP , in apparently healthy adults OBJECTIVES This study sought to 1 ) determine the effect of gender on early and late infa rct -related artery patency and reocclusion after  thrombolytic therapy for acute myocardial infa rct ion ; 2 ) examine the effect of gender on left ventricular function in response to injury/reperfusion ; and 3 ) assess the independent contribution of gender to early ( 30-day ) mortality after acute myocardial infa rct ion . BACKGROUND Women have a higher mortality rate than men after myocardial infa rct ion . However , the effect of gender on infa rct -related coronary artery patency and left ventricular response to injury/reperfusion have not been fully defined in the thrombolytic era . METHODS Patency rates and global and regional left ventricular function were determined in patients at 90 min and 5 to 7 days after thrombolytic therapy for acute myocardial infa rct ion . The effect of gender on infa rct -related artery patency and left ventricular function was determined . Thirty-day mortality differences between women and men were compared . RESULTS Women were significantly older and had more hypertension , diabetes , hypercholesterolemia , heart failure and shock . They were less likely to have had a previous myocardial infa rct ion , history of smoking or previous bypass surgery . Ninety-minute patency rates ( Thrombolysis in Myocardial Infa rct ion [ TIMI ] flow grade 3 ) in women and men were 39 % and 38 % , respectively ( p = 0.5 ) . Reocclusion rates were 8.7 % in women versus 5.1 % in men ( p = 0.14 ) . Women had more recurrent ischemia than men ( 21.4 % vs. 17.0 % , respectively , p = 0.01 ) . Ninety-minute ejection fraction and regional ventricular function were clinical ly similar in women and men with TIMI 2 or 3 flow ( ejection fraction [ mean + /- SD ] : 63.4 + /- 6 % vs. 59.4 + /- 0.7 % , p = 0.02 ; number of chords : 21.4 
    Output:
    
There was no significant sex difference in CV mortality