Predictive Value of Cumulative Blood Pressure for All-Cause Mortality and Cardiovascular Events

Area of Science:

• Cardiology
• Epidemiology
• Public Health

Background:

• The predictive value of cumulative blood pressure (BP) on mortality and cardiovascular and cerebrovascular events (CCE) is not well-established.
• Previous studies have primarily focused on current BP levels, overlooking the long-term impact of sustained BP exposure.

Purpose of the Study:

• To investigate the predictive value of cumulative systolic blood pressure (cumSBP) and cumulative diastolic blood pressure (cumDBP) on all-cause mortality and CCEs.
• To analyze the relationship between cumulative BP and specific cardiovascular outcomes like stroke and myocardial infarction (MI).

Main Methods:

• A prospective cohort study involving 52,385 participants from the Kailuan Group with three medical examinations and no prior CCE.
• Multivariate Cox proportional hazards regression analysis was used to assess the association between cumSBP, cumDBP, and adverse outcomes.
• Natural spline function analysis was employed to explore the shape of the relationship between cumulative BP and CCEs/stroke.

Main Results:

• Increased cumSBP and cumDBP were significantly associated with higher hazard ratios for all-cause mortality, CCEs, and stroke.
• Specifically, a 10 mmHg·year increase in cumSBP and a 5 mmHg·year increase in cumDBP elevated the risk of all-cause mortality and CCEs.
• A J-curve relationship was observed between cumSBP/cumDBP and CCEs, while a U-curve relationship was found with stroke, indicating complex associations.

Conclusions:

• Cumulative systolic and diastolic blood pressure are significant predictors of all-cause mortality, cardiovascular and cerebrovascular events, and stroke.
• The findings highlight the importance of long-term BP management in preventing major adverse cardiovascular outcomes.
• Sustained elevated BP over time, as reflected by cumulative measures, poses a substantial risk to cardiovascular health.