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Association between blood pressure levels and cardiovascular deaths: a 20-year follow-up study in rural China.

ABSTRACT: OBJECTIVES:The 2017 American College of Cardiology/American Heart Association (ACC/AHA) hypertension guideline recommended 130/80 mm Hg as blood pressure (BP) target goals. However, the generalisability of this recommendation to populations at large with hypertension remains controversial. We assessed the association between BP and cardiovascular diseases (CVDs) mortality using a 20-year follow-up study among Chinese populations. DESIGN:Prospective cohort study. PARTICIPANTS:7314 participants were followed up for a median of 20 years in Fangshan District, Beijing, China. METHODS:The primary outcome variable was death from cardiovascular causes. The adjusted HR for CVDs mortality associated with baseline BP was calculated using Cox regression analysis. RESULTS:We identified 350 deaths from CVDs (148 stroke, 113 coronary heart disease and 89 other CVDs) during follow-up. Hypertension (defined by systolic BP (SBP)/diastolic BP (DBP) ?140/90 mm Hg) was significantly associated with mortality due to CVDs (HR=2.49, 95% CI=1.77 to 3.50) among people aged 35-59 years rather than people aged ?60 years. In addition, there was no significant association between stage 1 hypertension defined by the 2017 ACC/AHA (SBP/DBP of 130-139/80-89 mm Hg) and CVDs mortality when compared with SBP/DBP of <120/80 in neither the participants aged <60 years (HR=0.90, 95% CI=0.54 to 1.50) nor participants aged ?60 years (HR=1.47, 95% CI=0.94 to 2.29). CONCLUSION:The study revealed hypertension of SBP/DBP?140/90 mm Hg was an important risk factor of CVDs mortality, especially among people aged 35-59 years. However, stage 1 hypertension under the definition of 2017 ACC/AHA was not associated with an increased risk of CVDs mortality. This study indicated that whether adopting the new hypertension definition needs further consideration in rural Chinese populations.

SUBMITTER: Wang M

PROVIDER: S-EPMC7045167 | biostudies-literature | 2020 Feb

REPOSITORIES: biostudies-literature

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Association between blood pressure levels and cardiovascular deaths: a 20-year follow-up study in rural China.

Wang Mengying M Wu Tao T Yu Canqing C Gao Wenjing W Lv Jun J Wu Yiqun Y Qin Xueying X Tang Xun X Gao Pei P Zhan Siyan S Cao Weihua W Zhao Qingshui Q Huang Shaoping S Yang Dongli D Li Liming L Hu Yonghua Y

BMJ open 20200225 2

<h4>Objectives</h4>The 2017 American College of Cardiology/American Heart Association (ACC/AHA) hypertension guideline recommended 130/80 mm Hg as blood pressure (BP) target goals. However, the generalisability of this recommendation to populations at large with hypertension remains controversial. We assessed the association between BP and cardiovascular diseases (CVDs) mortality using a 20-year follow-up study among Chinese populations.<h4>Design</h4>Prospective cohort study.<h4>Participants</h ...[more]

PMID: 32102826

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Project description:A meta-analysis was performed on studies employing the ventricular-brain ratio to compare schizophrenic subjects to that of normal controls. This was a follow-up to a similar meta-analysis published in 1992 in which study-, in addition to clinical-, factors were found to contribute significantly to the reported difference between patients with schizophrenia and controls. Seventy-two (N=72) total studies were identified from the peer reviewed literature, 39 from the original meta-analysis, and 33 additional studies published since which met strict criteria for inclusion and analysis - thus representing ~30 years of schizophrenia ventricular enlargement research. Sample characteristics from schizophrenics and controls were coded for use as predictor variables against within sample VBR values as well as for between sample VBR differences. Additionally, a number of factors concerning how the studies were conducted and reported were also coded. Obtained data was subjected to unweighted univariate as well as multiple regression analyses. In particular, results indicated significant differences between schizophrenics and controls in ventricular size but also the influence of the diagnostic criteria used to define schizophrenia on the magnitude of the reported VBR. This suggests that differing factors of the diagnostic criteria may be sensitive to ventricular enlargement and might be worthy of further examination. Interestingly, we observed an inverse relationship between VBR difference and the number of co-authors on the study. This latter finding suggests that larger research groups report smaller VBR differences and may be more conservative or exacting in their research methodology. Analyses weighted by sample size provided identical conclusions. The effects of study factors such as these are helpful for understanding the variation in the size of the reported differences in VBR between patients and controls as well as for understanding the evolution of research on complex clinical syndromes employing neuroimaging morphometrics.

Dataset Information

Association between blood pressure levels and cardiovascular deaths: a 20-year follow-up study in rural China.

Publications

Association between blood pressure levels and cardiovascular deaths: a 20-year follow-up study in rural China.

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