Key result
Systolic blood pressure of 140-159 mmHg increased the risk of first-ever stroke by 58% compared to systolic blood pressure <130 mmHg in a low-income Chinese population.
Why the study?
The association between stroke risk and the 2017 blood pressure criteria was unknown in China.
Does elevated blood pressure increase the risk of first-ever stroke in a low-income Chinese population?
Cohort (n=4,017)
No
Does elevated blood pressure increase the risk of first-ever stroke in a low-income Chinese population?
Effect estimate: HR 1.58 (95% CI 1.26-1.99)
p-value: p=<0.05
In a low-income Chinese population, SBP ≥140 mmHg or DBP ≥90 mmHg significantly increased the risk of overall and ischemic stroke, while hemorrhagic stroke risk increased at SBP ≥160 mmHg.
Supports targeted BP screening in low-income Chinese adults; extends stroke risk data to this population but leaves generalizability and causality open.
Association of stroke risk with new blood pressure criterion 2017 is unknown in China. We assessed the association between blood pressure (BP) values and stroke risk in a low-income population in Tianjin, China. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) values were categorized into five strata and strokes were recorded as stroke, ischemic stroke, and hemorrhagic stroke. Stroke risk was analyzed according to blood pressure stratum using Cox regression analysis. Overall, 4,017 residents (age, ≥18 years) were included in this prospective cohort study. Over a 27-year follow-up period (total, 86,515.78 person-years), 638 participants experienced first-ever strokes. The stroke risk was higher among individuals with SBPs ≥140 mmHg or DBPs ≥90 mmHg than among those with SBPs < 130 mmHg or DBPs < 80 mmHg (reference group), after adjusting for covariates. However, hemorrhagic stroke risk increased only in participants with SBPs ≥160 mmHg. The stroke risk increased for individuals < 65-years-old having BP values ≥130/80 mmHg and for individuals ≥65-years-old with BP values ≥160/90 mmHg. To reduce the stroke burden in China, target BP goals must be established for adults, with different targets for the middle-aged and the elderly segments of the population. These results are very important for guiding clinical practice and may be generalized to other developing countries experiencing rapid economic development and where transitions in the spectrum of prevalent diseases have occurred.
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Du et al. (2019) conducted a cohort in Stroke (n=4,017). Systolic blood pressure 140-159 mmHg vs. Systolic blood pressure <130 mmHg was evaluated on First-ever stroke (HR 1.58, 95% CI 1.26-1.99, p=<0.05). Systolic blood pressure of 140-159 mmHg increased the risk of first-ever stroke by 58% compared to systolic blood pressure <130 mmHg in a low-income Chinese population.
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