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Baseline and longitudinal change in blood pressure and mortality in a Chinese cohort

Jian-Bing Wang1,2, Qiu-Chi Huang1, Shu-Chang Hu1

  • 1Department of Epidemiology and Biostatistics, School of Public Health, Zhejiang University, Hangzhou, China.

Journal of Epidemiology and Community Health
|August 6, 2018
PubMed

Insights

Low blood pressure (hypotension) and stage 3 hypertension increase all-cause mortality risk. Rising blood pressure from normal or prehypertension levels also elevates total and cardiovascular mortality risk.

Area of Science:

  • Cardiology
  • Public Health
  • Epidemiology

Background:

  • The relationship between blood pressure (BP) and mortality often follows a J-curve, but longitudinal BP changes in Chinese populations are understudied.
  • Existing research on BP and mortality lacks data on longitudinal BP changes within Chinese populations.

Purpose of the Study:

  • To investigate the association between baseline BP, longitudinal BP changes, and mortality risk in a Chinese cohort.
  • To analyze how variations in blood pressure over time impact overall and cause-specific mortality.

Main Methods:

  • A retrospective cohort study was conducted using the Yinzhou Health Information System in Ningbo, China.
  • Data from 168,061 participants aged over 18 with baseline BP records were analyzed, excluding outliers.
  • BP levels at baseline and changes over time were assessed against mortality outcomes.

Main Results:

  • A U-shaped association was found between baseline BP and total/cardiovascular mortality.
  • Hypotension (HR=1.51) and stage 3 hypertension (HR=1.28) were linked to increased all-cause mortality compared to normotension.
  • BP increases from normotension to hypertension or prehypertension to hypertension significantly raised total and cardiovascular mortality risks.

Conclusions:

  • Hypotension and stage 3 hypertension are significant risk factors for all-cause mortality.
  • Progressive increases in blood pressure to 140/90 mmHg or higher, even from normal or prehypertensive levels, are associated with elevated total and cardiovascular mortality.
  • Monitoring BP trends and managing BP changes are crucial for reducing mortality risk.
Abstract

Keywords:
blood pressurecardiovascular diseasecohort studiesstroke

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