Key result
Blood pressure ≥140/90 mmHg increased CVD risk in general (HR 2.68), while BP 130-139/80-89 mmHg only increased risk in those with 10-year ASCVD risk ≥10% (HR 3.82) or diabetes.
Why the study?
Does a blood pressure of 130-139/80-89 mmHg increase the risk of incident cardiovascular disease in Chinese adults with different glucose metabolism compared to BP <130/80 mmHg?
Cohort (n=2,132)
Does a blood pressure of 130-139/80-89 mmHg increase the risk of incident cardiovascular disease in Chinese adults with different glucose metabolism compared to BP <130/80 mmHg?
Hazard Ratio: 2.68 (95% CI 1.36–5.25)
Absolute Event Rate: 13.9% vs 3%
A blood pressure of 130-139/80-89 mmHg is associated with increased CVD risk in Chinese adults with diabetes or high baseline ASCVD risk, but not in those with normoglycemia or prediabetes.
May warrant closer BP monitoring in glucose-impaired adults; leaves open optimal targets pending randomized confirmation.
OBJECTIVE: To investigate cardiovascular disease (CVD) risks caused by blood pressure (BP) of 130-139/80-89 mmHg among Chinese adults with different glucose metabolism. RESEARCH DESIGN AND METHODS: A prospective population-based cohort of 2,132 adults in Shanghai was established in 2002, and CVD information was collected during 10.9 years of follow-up. After assessing the association between BP categories and incident CVD, we analyzed the risk for CVD by blood glucose categories and BP categories combined by using multiple Cox regression analysis among 1,419 participants at follow-up. RESULTS: The corresponding incidence of CVD per 1,000 person-years for the BP <130/80 mmHg, 130-139/80-89 mmHg, and ≥140/90 mmHg or treated groups were 3.0, 6.0, and 13.9, respectively. After adjusting for age, sex, and other factors, BP ≥140/90 mmHg was significantly associated with a higher CVD risk in general (hazard ratio 2.68 [95% CI 1.36-5.25]) and in various blood glucose categories (normoglycemia 2.59, prediabetes 3.03, diabetes mellitus [DM] 4.98). However, BP of 130-139/80-89 mmHg was significantly associated with a higher CVD risk in an estimated baseline 10-year atherosclerotic CVD (ASCVD) risk ≥10% (3.82 [1.42-9.78]) or DM (3.54 [1.05-11.88]) but not in the general population or for a baseline 10-year ASCVD risk <10%, normoglycemia, or prediabetes. CONCLUSIONS: BP of 130-139/80-89 mmHg may result in a significantly higher CVD risk in Chinese adults with an estimated 10-year ASCVD risk ≥10% or DM but not in those with normoglycemia or prediabetes.
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Tian et al. (2018) conducted a cohort in Cardiovascular disease (n=2,132). Blood pressure ≥140/90 mmHg vs. Blood pressure <130/80 mmHg was evaluated on incident cardiovascular disease (HR 2.68, 95% CI 1.36-5.25). Blood pressure ≥140/90 mmHg increased CVD risk in general (HR 2.68), while BP 130-139/80-89 mmHg only increased risk in those with 10-year ASCVD risk ≥10% (HR 3.82) or diabetes.
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