Key result
Each 20 mmHg higher SBP is linked to ~102% greater CV mortality, alongside diabetes and BMI.
Why the study?
The relevance of major risk factors including systolic blood pressure, diabetes, and body-mass index to cardiovascular mortality in the Cuban population remains unclear.
Cohort (n=125,939)
Yes
Elevated systolic blood pressure, diabetes, and raised BMI are strongly associated with cardiovascular mortality in Cuba, accounting for a substantial proportion of premature deaths despite comparatively low baseline levels.
SBP, diabetes and BMI were associated with CV mortality in Cuba; extends prior evidence to this population but leaves open intervention effects.
BACKGROUND: Cardiovascular disease accounts for about one-third of all premature deaths (ie, age < 70) in Cuba. Yet, the relevance of major risk factors, including systolic blood pressure (SBP), diabetes, and body-mass index (BMI), to cardiovascular mortality in this population remains unclear. METHODS: In 1996-2002, 146,556 adults were recruited from the general population in five areas of Cuba. Participants were interviewed, measured (height, weight and blood pressure) and followed up by electronic linkage to national death registries until Jan 1, 2017; in 2006-08, 24,345 participants were resurveyed. After excluding all with missing data, cardiovascular disease at recruitment, and those who died in the first 5 years, Cox regression (adjusted for age, sex, education, smoking, alcohol and, where appropriate, BMI) was used to relate cardiovascular mortality rate ratios (RRs) at ages 35-79 years to SBP, diabetes and BMI; RR were corrected for regression dilution to give associations with long-term average (ie, 'usual') levels of SBP and BMI. RESULTS: ) accounted for 27%, 14%, and 16% of cardiovascular deaths, respectively. CONCLUSIONS: This large prospective study provides direct evidence for the effects of these major risk factors on cardiovascular mortality in Cuba. Despite comparatively low levels of these risk factors by international standards, the strength of their association with cardiovascular death means they nevertheless exert a substantial impact on premature mortality in Cuba.
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Rojas et al. (2021) conducted a cohort in Cardiovascular mortality (n=125,939). Elevated systolic blood pressure, diabetes, and raised body-mass index vs. Lower systolic blood pressure, no diabetes, and lower body-mass index was evaluated on Cardiovascular mortality at ages 35-79 years (RR 2.02, 95% CI 1.88-2.18). Each 20 mmHg higher usual systolic blood pressure approximately doubled the risk of cardiovascular mortality (RR 2.02), as did prior diabetes (RR 2.15) and a 10 kg/m2 higher usual BMI (RR 1.92).
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