Key result
High-normal baseline blood pressure was associated with an increased risk of incident hypertension compared to optimal blood pressure (HR 1.28; 95% CI 1.20-1.36).
Why the study?
Does baseline blood pressure level predict the risk of progression to incident hypertension in nonhypertensive rural Chinese adults?
Cohort (n=24,052)
Does baseline blood pressure level predict the risk of progression to incident hypertension in nonhypertensive rural Chinese adults?
Hazard Ratio: 1.28 (95% CI 1.2–1.36)
Absolute Event Rate: 32.4% vs 21.2%
There is a stepwise increase in the risk of progression to hypertension across baseline blood pressure levels in rural Chinese adults, underscoring the importance of frequent monitoring.
May support closer BP monitoring in high-normal adults; extends prior associations to rural Chinese but leaves causal effects open.
OBJECTIVES: To assess the risk of progression to hypertension across baseline blood pressure (BP) level among rural Chinese adults. METHODS: A population-based sample of 24 052 rural Chinese adults aged at least 35 years and free from hypertension at baseline were followed up from 2004-2006 to 2008. Incident hypertension was defined as SBP of at least 140 mmHg, DBP of at least 90 mmHg, current use of antihypertensive medication, or all. RESULTS: During a median follow-up of 28 months, 26.5% participants developed clinical hypertension, most of which were untreated and uncontrolled. The cumulative incidence of hypertension in participants with optimal, normal, and high-normal BP was 21.2, 25.2, and 32.4%, respectively. The higher incidence of hypertension (per 100 person-years) was obviously observed in higher BP category at baseline among both older and younger groups (both P for trend <0.05). Compared with optimal BP, the adjusted hazard ratios of participants with normal and high-normal BP for incident hypertension were 1.16 (95% confidence interval 1.08-1.24) and 1.28 (95% confidence interval 1.20-1.36), respectively. In addition, older age, men, Mongolian ethnicity, alcohol drinking, family history of hypertension, BMI, and change in BMI during follow-up were also independently associated with incident hypertension. CONCLUSION: There was a stepwise increase in risk of progression to hypertension across baseline BP level. This information could help us define a population at high risk of progression to hypertension, to underscore the importance of frequent BP monitoring, and early interventions in rural Chinese adults.
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Zheng et al. (2010) conducted a cohort in Nonhypertensive (n=24,052). High-normal baseline blood pressure vs. Optimal baseline blood pressure was evaluated on Incident hypertension (HR 1.28, 95% CI 1.20-1.36). High-normal baseline blood pressure was associated with an increased risk of incident hypertension compared to optimal blood pressure (HR 1.28; 95% CI 1.20-1.36).
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