Associations of blood pressure components with risks of cardiovascular events and all‐cause death in a Chinese population: A Prospective Study

Abstract

The associations of blood pressure components with cardiovascular risks and death remain unclear, and the definition of wide pulse pressure (PP) is still controversial. Using data from 1257 participants without a history of cardiovascular disease, who were followed for 4.84 years, we performed multivariable Cox regression analyses to assess how systolic blood pressure (SBP), diastolic blood pressure (DBP), and PP contribute to risks of cardiovascular events and all‐cause death. Among all participants, SBP and PP were significantly associated with the risks of cardiovascular events and all‐cause death (all p < .05). DBP was not significantly associated with the risk of all‐cause death; rather, it was only associated with a marginally significant 1% increased risk for cardiovascular events (p = 0.051). In participants aged < 65 years, DBP was significantly associated with a 3% increased risk for cardiovascular events (hazard ratio [HR]: 1.03, 95% confidence interval [95% CI]: 1.01–1.06). The association between PP and cardiovascular events appeared to be J‐shaped in comparison to participants with the lowest‐risk PP (50–60 mmHg), with adjusted HRs of 1.71 (95% CI: 1.03–2.85), 1.63 (95% CI: 1.00–2.68), and 2.13 (95% CI: 1.32–3.43) in the <50, 60.0–72.5, and ≥72.5 mmHg subgroups, respectively. The optimal cutoff points of a wide PP for predicting the risks of cardiovascular events and all‐cause death were 70.25 and 76.25 mmHg, respectively. SBP and PP had a greater effect on cardiovascular risk, whereas DBP independently influenced cardiovascular events in middle‐aged participants. Considerable PP alterations should be avoided in antihypertensive treatment.

Correlation between H-type hypertension and intracranial arterial dolichoectasia in hypertensive patients with acute ischemic stroke

“…H-type hypertension has the double harm of hypertension and HHCY, which is closely related to various diseases. A prospective cohort study by Zhang et al [7] found that H-type hypertension patients had cardiovascular events (HR = 2.44, 95%CI:1.28-4.65), stroke events (HR = 2.07, 95%CI:1.01-4.29), coronary artery disease events (HR = 8.33, 95%CI:1.01-63.11) and the risk of all-cause mortality (HR = 2.31, 95%CI:1.15-4.62) was the highest. Li et al [23] showed that compared with patients with isolated hypertension or HHCY, H-type hypertension patients had an increased risk of stroke by 12.7% and an increased risk of stroke death by 11.7%.…”

“…Studies have shown that hypertension and HHCY have a noticeable additive effect. The risk of cardiovascular and cerebrovascular diseases signi cantly increases in H-type hypertension individuals [7][8]. As a result, early intervention of H-type hypertension is particularly essential in the clinic.…”

Association of pulse pressure with all‐cause mortality in older Japanese patients with type 2 diabetes mellitus: A observational cohort study

“…Another study that followed 2152 New Haven residents who were 65 years and older for 10 years found that a 10‐mmHg increase in PP was associated with a 12% increased risk of developing coronary heart disease, 14% increased risk of developing congestive heart failure, and 6% increased risk of all‐cause mortality (Vaccarino et al, 2000). Zhang et al (2022) followed 1257 general population (466 <65 years old, 791 ≥65 years old) with no history of CVD for a mean of 4.84 years to examine the association between PP and all‐cause mortality. They found no significant association in the <65 years group, while 1 mmHg increase in PP was associated with 1% significantly increased risk of all‐cause mortality in the ≥65 years group.…”

“…Many studies have examined the association between PP and prognosis with inconsistent results. Most studies found an association between wide PP and increased cardiovascular events and all‐cause mortality (Hashemi et al, 2018; Li et al, 2020; Oh et al, 2018; Wang et al, 2022; Zhang et al, 2022; Zhao et al, 2014), and it was variously either explained as being due to SBP and DBP (Antikainen et al, 2000; Miura et al, 2001) or being weaker than observed for SBP and DBP (Bangalore et al, 2009). Others reported that PP cannot predict mortality (Pastor‐Barriuso et al, 2003).…”

“…Others reported that PP cannot predict mortality (Pastor-Barriuso et al, 2003). Although the participants' backgrounds among studies varied, PP, which reflects the progression of arterial stiffness with age, was generally associated with mortality risk in older adults (Zhang et al, 2022). However, few studies have examined the association between PP and prognosis in diabetic patients.…”