Key result
Systolic blood pressure was the strongest predictor of stroke among blood pressure parameters in rural Chinese patients with hypertension, with a hazard ratio of 1.109 per 5 mmHg increment.
Why the study?
Little was known about the different predictive power of various blood pressure parameters (SBP, MAP, PP, and DBP) for stroke incidence among rural Chinese individuals with hypertension.
Which blood pressure parameter (SBP, MAP, PP, or DBP) is the strongest predictor of incident stroke in rural Chinese patients with hypertension?
Cohort (n=5,097)
Yes
Which blood pressure parameter (SBP, MAP, PP, or DBP) is the strongest predictor of incident stroke in rural Chinese patients with hypertension?
Effect estimate: HR 1.109 (95% CI 1.089-1.130)
p-value: p=<0.001
In rural Chinese patients with hypertension, systolic blood pressure and mean arterial pressure are stronger predictors of incident stroke than pulse pressure or diastolic blood pressure.
May inform SBP-focused monitoring in rural hypertension; leaves open whether it guides therapy over other parameters.
Little was known about the different predictive power of blood pressure (BP) parameters (SBP, systolic BP; mean arterial pressure, MAP; pulse pressure, PP; and diastolic BP, DBP) and stroke incidence. This study’s aim was to compare power of BP parameters predict stroke events among rural dwelling Chinese individuals with hypertension. A total of 5097 hypertension patients (56.2% women; mean age, 56.3 ± 11.2 years) were included in the prospective cohort study with a median follow-up of 8.4 years. Until the end of the last follow-up, there were 501 onset strokes (310 ischemic, 186 hemorrhagic, and 5 unclassified strokes) among the 5097 participants. The results showed that hazard ratio (HR) (95% confidence interval, 95% CI) with an increment of 5 mmHg were 1.095 (1.070–1.121) for PP, 1.173 (1.139–1.208) for MAP, 1.109(1.089–1.130) for SBP, 1.143(1.104–1.185) for DBP. The SBP indicated the largest β coefficient in the Cox proportional hazard model for all stroke except PP or MAP, and the SBP revealed slightly higher value than MAP (βSBP = 0.435, βMAP = 0.430, P = 0.756). Both PP and MAP were predictive factors for stroke. The MAP showed a stronger ability to predict stroke events than PP, and slightly inferior to SBP for hypertension patients.
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Zheng et al. (2019) conducted a cohort in Hypertension (n=5,097). Systolic blood pressure (SBP) was evaluated on Incident stroke (HR 1.109, 95% CI 1.089-1.130, p=<0.001). Systolic blood pressure was the strongest predictor of stroke among blood pressure parameters in rural Chinese patients with hypertension, with a hazard ratio of 1.109 per 5 mmHg increment.
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