Key result
A rise in blood pressure from normotension to hypertension was associated with an increased risk of total mortality compared to stable normotension (HR 1.39; 95% CI 1.10-1.75).
Why the study?
Does baseline blood pressure and its longitudinal change affect the risk of total and cardiovascular mortality in a Chinese adult cohort?
Cohort (n=168,061)
Does baseline blood pressure and its longitudinal change affect the risk of total and cardiovascular mortality in a Chinese adult cohort?
Effect estimate: HR 1.39 (95% CI 1.10 to 1.75)
Both hypotension and severe hypertension, as well as longitudinal progression to hypertension, are associated with increased all-cause and cardiovascular mortality in a Chinese population.
BP progression to hypertension was associated with higher mortality; extends longitudinal BP data in Chinese adults but remains hypothesis-generating.
BACKGROUND: A J-curve association has been demonstrated for blood pressure (BP) and all-cause mortality, but data on longitudinal change of BP and mortality in Chinese population are limited. METHODS: We performed a retrospective cohort study to examine the association between BP (at baseline and longitudinal change) and risk of mortality in Yinzhou District, Ningbo, China, based on the Yinzhou Health Information System. At baseline, a total of 181 352 subjects aged over 18 years with at least one BP examination record were recruited through the Yinzhou Health Information System. The final analysis was restricted to 168 061 participants after exclusion of outliers of BP. RESULTS: A U-shaped association was observed for BP at baseline and risk of total and cardiovascular mortality. When compared with normotensive participants, patients with hypotension (HRs=1.51, 95% CI 1.21 to 1.88) and stage 3 hypertension (1.28, 95% CI 1.09 to 1.50) had an increased risk of all-cause mortality. Relative to stable BP of normotension, having a rise in BP from normotension to hypertension or from prehypertension to hypertension both conferred an increased risk of total and cardiovascular mortality (total: 1.39 (95% 1.10 to 1.75) and 1.40 (95% 1.15 to 1.69); cardiovascular: 2.22 (95% CI 1.35 to 3.65) and 1.89 (95% CI 1.20 to 2.96), respectively). CONCLUSIONS: Our findings emphasise that hypotension and stage 3 hypertension were associated with an increased risk of all-cause mortality. Longitudinal change from normotensive or prehypertensive levels to 140/90 mm Hg or higher could increase the risk of total and cardiovascular mortality.
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Wang et al. (2018) conducted a cohort in Blood pressure (n=168,061). Rise in blood pressure from normotension to hypertension vs. Stable BP of normotension was evaluated on total mortality (HR 1.39, 95% CI 1.10 to 1.75). A rise in blood pressure from normotension to hypertension was associated with an increased risk of total mortality compared to stable normotension (HR 1.39; 95% CI 1.10-1.75).
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