Key result
Each 10 mmHg increase in systolic blood pressure was associated with a 23% higher risk of the composite cardiovascular outcome (HR 1.23) in Chinese adults.
Why the study?
The association between blood pressure and cardiovascular outcomes had not been well investigated by large prospective studies in Chinese populations.
Does higher blood pressure increase the risk of cardiovascular outcomes in Chinese adults?
Cohort (n=4,569)
Yes
Does higher blood pressure increase the risk of cardiovascular outcomes in Chinese adults?
Hazard Ratio: 1.23 (95% CI 1.16–1.29)
p-value: p=<0.001
Both systolic and diastolic blood pressures are independently and linearly associated with an increased risk of cardiovascular outcomes, particularly stroke, in the Chinese population.
Highlights SBP as CV risk marker in Chinese adults; extends observational data but leaves practice change open.
Objective The association between blood pressure(BP) and cardiovascular outcomes has not been well investigated by large prospective studies on Chinese. We aim to analyze the association of BP with cardiovascular outcomes in Chinese population. Method We included a total of 4,569 adults aged 40–90 years from the China Health and Nutrition Survey (CHNS) cohort. Cox proportional hazards regression models were used to estimate hazard ratios and 95% CIs. Restricted cubic spline analyses were used to explore linear and nonlinear relationships of BP with cardiovascular outcomes. Result With a mean follow-up of 12.1 years, a total of 4,569 individuals were enrolled in our study, of whom 403 developed cardiovascular outcomes. Multivariable adjusted Cox models showed a strong positive association between BP and cardiovascular outcomes. SBP was significantly associated with composite outcome(HR per 10 mmHg 1.23[1.16–1.29]), myocardial infarction(MI)(HR per 10 mmHg 1.17[1.07–1.27]), and stroke(HR per 10 mmHg 1.29[1.21–1.38]). DBP was significantly associated with composite outcome(HR per 10 mmHg 1.32[1.20–1.44]), MI(HR per 10 mmHg 1.26[1.10–1.44]), and stroke(HR per 10 mmHg 1.39[1.25–1.55]). Restricted cubic spline analyses showed linear relationships of either SBP or DBP with composite outcome, MI and stroke. Conclusion Either SBP or DBP is independently and linearly related to the risk of cardiovascular outcomes. These associations are steeper for stroke than for MI, and vary widely by age, use of antihypertensive treatment, and diabetes status.
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Yu et al. (2021) conducted a cohort in Cardiovascular disease (n=4,569). Blood pressure (SBP and DBP) vs. Lower blood pressure categories (SBP 0-130 mmHg, DBP 0-80 mmHg) was evaluated on Composite of the first episode of myocardial infarction or stroke (HR 1.23, 95% CI 1.16-1.29, p=<0.001). Each 10 mmHg increase in systolic blood pressure was associated with a 23% higher risk of the composite cardiovascular outcome (HR 1.23) in Chinese adults.
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