Association of high-normal blood pressure defined by the 2023 European Society of Hypertension guideline with mortality in the Chinese population: a nationwide, population-based, prospective study of 3.6 million adults

Figures

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  Fig. 1. Flow chart of enrollment in the study population. Abbreviations: BP, blood pressure; BMI, body mass index; HDL, high-density lipoprotein; LDL, low-density lipoprotein; TC, total cholesterol; TG, triglyceride; CVD, cardiovascular disease. BP grouping criteria: 1) optimal: SBP < 120 mmHg and DBP < 80 mmHg; 2) normal: SBP:120–129 mmHg and DBP: 80–84 mmHg; 3) high-normal: SBP:130–139 mmHg and/or DBP: 85–89 mmHg; 4) hypertension: SBP ≥ 140 mmHg and/or DBP ≥ 90 mmHg

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  Fig. 2. SBP trajectory patterns during the follow-up. Abbreviations: SBP, systolic blood pressure; The participants included in this study had at least three SBP measurements. Optimal-stable: n = 20,419 (26.5%); normal-stable: n = 30,606 (38.3%); high-normal-stable: n = 23,363 (29.6%); high-normal-increasing: n = 3,742 (5.6%). Follow-up years represented the time since baseline enrollment, where 0 represented the baseline measurement

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  Fig. 3. Multivariable adjusted hazard ratios for all-cause and cause-specific mortality in BP group and BP trajectory during the follow-up. Abbreviations: BP, blood pressure; SBP, systolic blood pressure; DBP, diastolic blood pressure; BMI, body mass index; HDL, high-density lipoprotein; LDL, low-density lipoprotein; TC, total cholesterol; TG, triglyceride; CVD, cardiovascular disease; IHD, ischemic heart disease; COPD, chronic obstructive pulmonary disease; HRs: hazard ratios. Rates were calculated as per 1,000 person-years. HRs were estimated after adjusted for sex, age, region, education level, annual household income, urbanity, smoking, alcohol consumption, BMI, TC, HDL, LDL, TG, fasting blood glucose, medical history, dyslipidemia, anti-hypertensive drug use and high CVD risk. BP group and BP trajectory pattern grouping criteria are the same as the footnote in Figs. 1 and 2

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  Fig. 4. Population attributable risk for high-normal BP group and high-normal-increasing BP trajectory pattern. Abbreviations: PAR, population attributable risk; BP, blood pressure; CVD, cardiovascular disease. IHD, ischemic heart disease; COPD, chronic obstructive pulmonary disease. *NA represents the PAR value for COPD is too small to be estimated