Key result
Compared to a systolic blood pressure of 0-130 mmHg, a systolic blood pressure ≥180 mmHg was associated with a nearly four-fold increased risk of overall stroke (HR 3.90).
Why the study?
Previous findings regarding the association between blood pressure and stroke risk were controversial.
Does elevated systolic blood pressure increase the risk of stroke in Chinese adults aged 40-90 years?
Cohort (n=5,700)
Yes
Does elevated systolic blood pressure increase the risk of stroke in Chinese adults aged 40-90 years?
Hazard Ratio: 3.9 (95% CI 1.78–8.55)
p-value: p=<0.001
Systolic blood pressure is independently and directly related to the risk of overall stroke and its subtypes in the Chinese population, with higher risks of ischemic and hemorrhagic stroke when SBP exceeds 140 mmHg and 160 mmHg, respectively.
Extreme hypertension markedly raises stroke risk; extends observational cohorts but leaves causal effects and targets open for trials.
Objective : Previous results on the association between blood pressure(BP) and stroke risk were controversial. We investigated the association of BP with stroke risk in China. Method : We included a total of 5,700 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 and stroke. Result : With a median follow-up of 6 years, a total of 5,700 individuals were enrolled in our study, of whom 178 developed stroke. Multivariable adjusted Cox models including systolic blood pressure(SBP) and diastolic blood pressure(DBP) showed a strong positive association between SBP and overall stroke. Compared with participants with SBP 0-130 mmHg, the multivariable adjusted HRs[95% CIs] in participants with SBP 130-140, 140-160, 160-180, and ≥180 mmHg were 1.08[0.62-1.89], 2.41[1.51-3.86], 2.21[1.16-4.20], and 3.90[1.78-8.55] for overall stroke; 0.65[0.21-2.04], 3.68[1.73-7.83], 2.51[0.84-7.47], and 5.91[1.69-20.60] for ischemic stroke; 1.26[0.50-3.20], 1.19[0.47-3.04], 2.06[0.66-6.41], and 5.10[1.36-19.20] for hemorrhagic stroke. Restricted cubic spline analyses including SBP and DBP showed linear relationships of SBP with overall, ischemic and hemorrhagic stroke. No linear or nonlinear relationships of DBP with overall, ischemic and hemorrhagic stroke were observed. Conclusion : SBP is independently and directly related to the risk of overall and its subtypes. Besides, the risk of ischemic and hemorrhagic stroke might be higher when SBP were more than 140 mmHg and 160 mmHg.
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Yu et al. (2021) conducted a cohort in Stroke (n=5,700). Systolic blood pressure ≥180 mmHg vs. Systolic blood pressure 0-130 mmHg was evaluated on Overall stroke (HR 3.90, 95% CI 1.78-8.55, p=<0.001). Compared to a systolic blood pressure of 0-130 mmHg, a systolic blood pressure ≥180 mmHg was associated with a nearly four-fold increased risk of overall stroke (HR 3.90).
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