Related Experiment Video
Updated: Feb 11, 2026
In Silico Clinical Trials for Cardiovascular Disease
Published on: May 27, 2022
Longitudinal change in blood pressure is associated with cardiovascular disease mortality in a Chinese cohort
Jin-Hu Fan1, Jian-Bing Wang2, Shao-Ming Wang1
1Department of Cancer Epidemiology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
Insights
Rising blood pressure (BP) significantly increases mortality risk in Chinese adults. Developing hypertension, even from normal levels, elevates risks for all-cause, cardiovascular disease, and stroke mortality.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- Numerous studies indicate a J-shaped relationship between blood pressure (BP) and all-cause mortality.
- Limited research has explored the impact of longitudinal BP changes on mortality within the Chinese population.
Purpose of the Study:
- To investigate the association between baseline BP, longitudinal BP changes, and mortality risk.
- To examine BP trajectory patterns and their subsequent impact on mortality in a Chinese cohort.
Main Methods:
- A 30-year follow-up study of the Linxian General Population Trial Cohort (29,439 participants).
- Analysis of BP at baseline and over time (1985-2014), including BP trajectory patterns (1985-1999).
- Adjusted Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).
Main Results:
- Prehypertension, stage 1, 2, and 3 hypertension were associated with increased all-cause mortality risk (HRs ranging from 1.09 to 2.14) compared to normal BP.
- A rise in BP from normotension to hypertension or prehypertension to hypertension increased total mortality (HRs 1.22, 1.36), cardiovascular disease mortality (HRs 1.42, 1.55), and stroke mortality (HRs 2.29, 2.61).
Conclusions:
- Incident hypertension in middle age is linked to higher risks of total, cardiovascular disease, and stroke mortality.
- Findings suggest a need to potentially revise current blood pressure targets.
Background:
A number of studies have demonstrated a J-shaped curve between blood pressure (BP) and all-cause mortality, but few studies have used longitudinal change in BP to study mortality in the Chinese population.
Methods:
We performed a 30-year follow-up study to examine the association between BP (at baseline and longitudinal change) and risk of mortality in the Linxian General Population Trial Cohort. At baseline, a total of 29 584 healthy adults were enrolled in the Linxian General Population Trial in 1985 and followed through to the end of 2014. The final analysis was restricted to 29 439 participants (55% women) after exclusion of outliers. We also examined the potential effects of BP trajectory patterns during the period of 1985-1999 on sequent risk of mortality. Adjusted Cox proportional hazards models were used to estimate HRs and 95% CIs.
Results:
Compared with participants with normal BP, patients with prehypertension, stage 1, stage 2 or stage 3 hypertension had an increased risk of all-cause mortality, with HRs of 1.09 (95% CI 1.05 to 1.14), 1.34 (95% CI 1.28 to 1.40), 1.69 (95% CI 1.60 to 1.79) and 2.14 (95% CI 2.01 to 2.28), respectively. Relative to stable BP of normotension, having a rise in BP from normotension to hypertension or from prehypertension to hypertension both conferred an increased risk of total and cardiovascular disease and stroke mortality (total: HRs 1.22 (95% CI 1.12 to 1.34) and 1.36 (95% CI 1.23 to 1.51); cardiovascular disease: HRs 1.42 (95% CI 1.17 to 1.73) and 1.55 (95% CI 1.24 to 1.93); stroke: HRs 2.29 (95% CI 1.88 to 2.80) and 2.61 (95% CI 2.11 to 3.24), respectively).
Conclusions:
These findings emphasise that development of incident hypertension in middle age could increase the risk of total, cardiovascular disease and stroke mortality, and suggest that current BP targets could be revised.
Trial Registration Number:
NCT00342654;Post-results.
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