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Deaths from total and premature cardiovascular disease associated with high normal blood pressure and hypertension in rural Chinese men and elderly people

Journal of Human Hypertension volume 35, pages 741–750 (2021)Cite this article

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Abstract

To investigate the association of blood pressure (BP) categories with total and premature cardiovascular disease (CVD) mortality in rural Chinese. The study included 14,539 adults ≥18 years in rural China. Baseline study visits were conducted in 2007–2008, and follow-up visits in 2013–2014. Data were collected by face-to-face questionnaire interview, and anthropometric and laboratory measurements. A sub-distribution hazards model was used to calculate adjusted sub-distribution hazard ratios (aSHRs) and 95% confidence intervals (CIs). During the 6-year follow-up, 257 total and 209 premature CVD deaths occurred. As compared with normal BP (systolic BP/diastolic BP (SBP/DBP) < 120/80 mmHg), for men and people aged ≥60 years, hypertension (SBP/DBP ≥ 140/90 mmHg) associated with total CVD mortality (aSHR 3.57, 95% CI 2.06–6.17; aSHR 2.15, 1.29–3.56) and premature CVD mortality (aSHR 4.41, 2.37–8.21; aSHR 2.31, 1.27–4.19). Also, as compared with normal BP, for men and people aged ≥60 years with high normal BP (SBP/DBP 120–139/80–89 mmHg), risk of total CVD mortality increased (aSHR 1.85, 1.05–3.28; aSHR 1.78, 1.05–3.04), as was premature CVD mortality (aSHR 1.89, 0.99–3.64; aSHR 1.91, 1.03–3.54). Among men and people aged ≥60 years in rural China, risk of total and premature CVD mortality was increased for those with high normal BP and hypertension. Prevention and treatment strategies for additional CVD risk reduction targeting men and elderly people with hypertension or even high normal BP are needed to reduce CVD mortality risk.

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Acknowledgements

The investigators are grateful to the dedicated participants and all research staff of the study.

Funding

This study was supported by the National Natural Science Foundation of China (grant numbers 81373074, 81402752, and 81673260); the Natural Science Foundation of Guangdong Province (grant number 2017A030313452); the Medical Research Foundation of Guangdong Province (grant number A2017181); and the Science and Technology Development Foundation of Shenzhen (grant numbers JCYJ20140418091413562, JCYJ20160307155707264, JCYJ20170302143855721, and JCYJ20170412110537191).

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Authors and Affiliations

  1. The Affiliated Luohu Hospital of Shenzhen University Health Science Center, Shenzhen, Guangdong, People’s Republic of China

    Leilei Liu, Yu Liu, Yongcheng Ren, Yang Zhao, Dechen Liu, Xu Chen, Cheng Cheng, Chunmei Guo, Quanman Li, Gang Tian, Minghui Han, Ranran Qie, Ruirong Cheng, Dongsheng Hu, Jian Wang & Ming Zhang

  2. Study Team of Shenzhen’s Sanming Project, The Affiliated Luohu Hospital of Shenzhen University Health Science Center, Shenzhen, Guangdong, People’s Republic of China

    Leilei Liu, Yu Liu, Yongcheng Ren, Yang Zhao, Pei Qin, Dechen Liu, Xu Chen, Cheng Cheng, Feiyan Liu, Chunmei Guo, Qionggui Zhou, Quanman Li, Gang Tian, Minghui Han, Ranran Qie, Xiaoyan Wu, Ruirong Cheng, Dongsheng Hu, Jian Wang & Ming Zhang

  3. School of Public Health, Shenzhen University Health Science Center, Shenzhen, Guangdong, People’s Republic of China

    Yongcheng Ren, Yang Zhao, Feiyan Liu, Chunmei Guo, Qionggui Zhou, Quanman Li, Gang Tian, Minghui Han, Ranran Qie, Xiaoyan Wu, Xinping Luo & Dongsheng Hu

  4. Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People’s Republic of China

    Yongcheng Ren, Yang Zhao, Chunmei Guo, Minghui Han, Ranran Qie, Shengbing Huang & Dongsheng Hu

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Liu, L., Liu, Y., Ren, Y. et al. Deaths from total and premature cardiovascular disease associated with high normal blood pressure and hypertension in rural Chinese men and elderly people. J Hum Hypertens 35, 741–750 (2021). https://doi.org/10.1038/s41371-020-0379-4

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