Key result
Prehypertension was associated with a significantly increased risk of major adverse cardiovascular events compared with normal blood pressure (HR 1.337; 95% CI 1.186-1.508; P<0.001).
Why the study?
The study was conducted to investigate the impact of JNC7-defined prehypertension on the risk of major adverse cardiovascular events in a Chinese rural cohort.
Does prehypertension increase the risk of major adverse cardiovascular events in a Chinese rural cohort?
Cohort (n=38,765)
Does prehypertension increase the risk of major adverse cardiovascular events in a Chinese rural cohort?
Hazard Ratio: 1.337 (95% CI 1.186–1.508)
p-value: p=<0.001
Prehypertension significantly increases the risk of MACE, CVD mortality, and stroke in a rural Chinese population, highlighting the need for early BP monitoring and intervention.
Suggests heightened MACE vigilance for prehypertension in rural China; leaves open whether early BP control improves outcomes.
BACKGROUND: The study was performed to investigate the impact of prehypertension defined by the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC7) on the risk of major adverse cardiovascular events (MACE) in a Chinese rural cohort. METHODS: The epidemiological prospective cohort study included 38,765 participants aged ≥35 years followed for a median of 12.5 years-divided into normal BP (n = 7,366), prehypertension (n = 18,095), and hypertension groups (n = 13,304)-were enrolled for the final analysis. Follow-up for MACE including cardiovascular disease (CVD) death, stroke and myocardial infarction (MI) was conducted. Adjusted Cox proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI). RESULTS: The age and sex-adjusted incidence of MACE and its subtypes rose progressively with elevation of BP levels (P < 0.001). After adjusting multivariable Cox proportional hazards, significant increases were observed from the prehypertensive group for incident MACE (HR = 1.337, 95% CI: 1.186-1.508, P < 0.001), CVD mortality (HR = 1.331, 95% CI: 1.109-1.597, P = 0.002), and stroke (HR = 1.424, 95% CI：1.237-1.639, P < 0.001) but not MI (P > 0.05) compared with normal BP. CONCLUSION: Prehypertensive individuals had a greater risk of incident MACE, CVD mortality, and stroke, implying that improvements in BP monitoring and early intervention in individuals with prehypertension in rural China are urgently needed.
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Duan et al. (2020) conducted a cohort in Prehypertension (n=38,765). Prehypertension vs. Normal blood pressure was evaluated on Major adverse cardiovascular events (MACE) including cardiovascular disease death, stroke, and myocardial infarction (HR 1.337, 95% CI 1.186-1.508, p=<0.001). Prehypertension was associated with a significantly increased risk of major adverse cardiovascular events compared with normal blood pressure (HR 1.337; 95% CI 1.186-1.508; P<0.001).
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