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Relationship between diastolic blood pressure and the first ischaemic stroke in elderly patients with hypertension
Chao-Lei Chen1, Jia-Yi Huang1, Lin Liu1
1Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, School of Medicine, South China University of Technology, Guangzhou, China.
Insights
Diastolic blood pressure (DBP) shows a non-linear link to ischaemic stroke risk in hypertensive seniors. A DBP range of 70-80 mmHg may indicate a lower risk for stroke in this population.
Area of Science:
- Cardiology
- Neurology
- Geriatrics
Background:
- The association between diastolic blood pressure (DBP) and ischaemic stroke risk in elderly hypertensive patients remains unclear.
- This study investigates this relationship within a Chinese community setting.
Purpose of the Study:
- To explore the association between different diastolic blood pressure (DBP) levels and the incidence of ischaemic stroke.
- To identify optimal DBP ranges for reducing stroke risk in hypertensive elderly individuals.
Main Methods:
- A cohort of 3315 elderly patients (≥60 years) with essential hypertension was followed for 5.5 years.
- Diastolic blood pressure (DBP) levels were categorized, with 70-80 mmHg as the reference group.
- Cox regression analysis was used to assess the relationship between DBP and ischaemic stroke incidence.
Main Results:
- A total of 206 ischaemic strokes occurred during the follow-up period.
- Higher DBP levels (80-89.9 mmHg and ≥90 mmHg) were associated with increased ischaemic stroke risk compared to the 70-80 mmHg group.
- A trend (p=0.020) indicated a non-linear association between DBP and stroke risk.
Conclusions:
- Diastolic blood pressure (DBP) exhibits a non-linear association with ischaemic stroke risk in elderly Chinese hypertensive patients.
- Maintaining DBP between 70 and 80 mmHg may be associated with a reduced risk of ischaemic stroke.
Background:
It is uncertain how diastolic blood pressure (DBP) may associate with ischaemic stroke in elder patients with hypertension. We aimed to explore this relationship in a Chinese community.
Methods:
A total of 3315 participants aged ≥60 years with essential hypertension were enrolled between January 2010 and December 2011, and being followed up until 31 December 2016. DBP levels were categorised into five groups (<60, 60-70, 70-80, 80-90 and ≥90 mm Hg), using 70-80 mm Hg as referent. We performed Cox regression analysis and subgroup analyses to evaluate the relationship between DBP and the incidence of ischaemic stroke.
Results:
Among the 3315 participants, 44.49% were men and they were 71.4 years old on average. During a median follow-up period of 5.5 years, there were 206 onset cases of ischaemic stroke. The HRs for the first ischaemic stroke in the fully adjusted model were 1.32 (95% CI 0.73 to 2.40) for DBP <70 mm Hg, 1.50 (95% CI 1.13 to 2.73) for DBP between 80 and 89.9 mm Hg and 2.31 (95% CI 1.14 to 4.68) for DBP ≥90 mm Hg compared with DBP between 70 and 79.9 mm Hg (p=0.020 for trend). Subgroup and interaction analysis showed no significant findings.
Conclusions:
DBP had a non-linear association with the risk of ischaemic stroke among Chinese elderly patients with hypertension. DBP between 70 and 80 mm Hg may be an appropriate indicator for a lower stroke risk.
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