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Association between blood pressure multi-trajectory and cardiovascular disease among a Chinese elderly medical
Quan Chen1,2, Jinling Du3, Xin Hong1
1Department of Noncommunicable Disease Prevention, Nanjing Center for Disease Control and Prevention Affiliated to Nanjing Medical University, Nanjing, Jiangsu, China.
Insights
Higher blood pressure trajectories in Chinese elderly individuals are linked to increased cardiovascular disease (CVD) risk. This study identified four blood pressure subclasses, with higher classes showing greater CVD incidence.
Area of Science:
- Gerontology
- Cardiovascular Medicine
- Epidemiology
Background:
- Cardiovascular disease (CVD) is a major health concern in aging populations.
- Understanding blood pressure (BP) trajectories is crucial for predicting CVD risk.
Purpose of the Study:
- To characterize multivariate trajectories of systolic blood pressure (SBP) and diastolic blood pressure (DBP) in Chinese elderly individuals.
- To examine the association between these BP trajectories and incident CVD.
Main Methods:
- Utilized group-based trajectory modeling on 13,504 Chinese elderly individuals from 2018-2020.
- Analyzed incident CVD events (stroke, coronary heart disease) in 2021 using Cox proportional hazards models.
Main Results:
- Identified four distinct BP trajectory classes, with increasing SBP and DBP levels.
- Higher BP classes (2, 3, and 4) showed significantly increased adjusted hazard ratios for CVD events compared to class 1.
- Class 4 had the highest adjusted HR of 1.88 (95% CI: 1.24-2.85).
Conclusions:
- Higher concurrent SBP and DBP trajectories are associated with elevated risk of incident CVD in the Chinese elderly.
- These findings highlight the importance of monitoring longitudinal BP patterns for CVD prevention in this demographic.
Objective:
This study aimed to characterize multivariate trajectories of blood pressure [systolic blood pressure (SBP) and diastolic blood pressure (DBP)] jointly and examine their impact on incident cardiovascular disease (CVD) among a Chinese elderly medical examination population.
Methods:
A total of 13,504 individuals without CVD during 2018-2020 were included from the Chinese geriatric physical examination cohort study. The group-based trajectory model was used to construct multi-trajectories of systolic blood pressure and diastolic blood pressure. The primary outcome was the incidence of the first CVD events, consisting of stroke and coronary heart diseases, in 2021. The Cox proportional hazards model was used to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between BP multi-trajectories and incident CVD events.
Results:
We identified four blood pressure (BP) subclasses, summarized by their SBP and DBP levels from low to high as class 1 (7.16%), class 2 (55.17%), class 3 (32.26%), and class 4 (5.41%). In 2021, we documented 890 incident CVD events. Compared with participants in class 1, adjusted HRs were 1.56 (95% CI: 1.12-2.19) for class 2, 1.75 (95% CI: 1.24-2.47) for class 3, and 1.88 (95% CI: 1.24-2.85) for class 4 after adjustment for demographics, health behaviors, and metabolic index. Individuals aged 65 years and above with higher levels of BP trajectories had higher risks of CVD events in China.
Conclusions:
Individuals with higher levels of both SBP and DBP trajectories over time were associated with an increased risk of incident CVD in the Chinese elderly population.
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